How to avoid cancer: the main principles

Main risk factors and prevention

Today, a huge number of oncological diseases are known. We must know the main ones and pay attention to their prevention. This is entirely within our power.

Lung cancer is one of the three most common oncopathologies in Russia, one person dies from this disease every 10 minutes. In almost half of patients, it develops at working age, mainly at 55-65 years. Lung cancer is the leading cause of death from cancer: in 2019, it caused more than 60,000 deaths in Russia. At the same time, about 70% of cases of this pathology are diagnosed already at stages III and IV. Smoking is a major factor in the development of lung cancer, as well as cardiovascular disease and chronic obstructive pulmonary disease (COPD). Cigarette smoke impairs vascular coagulation, damages the walls of blood vessels, causes irritation and inflammation of internal organs, provoking cardiovascular, oncological pathologies and COPD. Lung cancer is directly related to exposure to carcinogens in tobacco smoke.

Breast cancer (BC) is the leader in the structure of cancer incidence. More than 2 million new cases are detected annually in the world, the annual increase in incidence in women of reproductive age 19-39 years is 34%. About 80 risk factors for breast cancer are known, the most important of which are age, late first birth, limited number of births and lactation, excessive fat intake, overweight and obesity. Today, the only solution is enhanced primary and secondary prevention (mammography screening), especially at the age of 50–69 years.

Colorectal cancer (CRC) is cancer of the rectum and colon. The most important risk factors are hereditary, as well as age. The frequency of cases of CRC per 100 people per year increases with age: less than 1 case – in 50 years; 3 – at the age of 70; 4.5 – 80 years and older. Dependent on heredity, screening by colonoscopy or fibroendoscopy is required at intervals from 1 time in six months to 1 time in 5 years. Taking into account the age factor, regular screening is recommended: people aged 45 years and older are required to have regular fecal occult blood testing and colonoscopy.

Cervical cancer (CC) is well understood and preventable. The main risk factor is the failure to perform regular screening: non-visiting a doctor, insufficient cytological diagnosis. Associated risk factors: viral infection (human papillomavirus – HPV, herpes simplex, cytomegalovirus); smoking; early onset of sexual activity; the presence of partners from social risk groups; non-compliance with sexual hygiene; venereal diseases; immunodeficiency, etc.

Ovarian cancer (fallopian tube cancer, primary peritoneal carcinoma) is an extremely aggressive form of the tumor, it does not have a staged development, screening and early detection are impossible. Risk factors: age, genetic factors, obesity, reproductive factors, unrealized reproductive function. In the prevention of endometrial and ovarian cancer, the role of combined oral contraception (COC) has been proven: the risk of cancer in women who use COCs is lower compared to those who have never used it.

Squamous cell carcinoma of the head and neck organs is localized in a complex anatomical zone, in its various areas: lip, oral cavity, larynx, nasopharynx; tumors of the oropharynx with a specific course and development; laryngopharyngeal tumors. Recently, the number of patients with a malignant tumor of the oral cavity has increased by 20%. Tumors of the head and neck are very often caused by tobacco smoking. In 90% of cases, an epithelial malignant neoplasm with extremely high aggressiveness is found – squamous cell carcinoma of the head and neck (SCNS). It is often diagnosed in stage III, sometimes stage IV, and has high mortality rates in the first year of diagnosis. Now, the identification of early signs and development factors of HNSS is an important task for oncologists and other doctors, to whom the patient comes for an initial appointment with any complaints: rounded formations on the neck, especially those that appeared more than 2 weeks ago; complaints of sudden or intermittent hoarseness of voice; problems in the oral cavity – periodic pain syndrome or discomfort; seals in the mucous membrane of the oral cavity and oropharynx, etc. For example, 13% of patients with tumors of the oral cavity turn to oncological institutions, and 87% – to specialists of a different profile. HRNS can be detected by routine dental or ENT x-ray examination, helical computed or cone beam tomography, and palpation of the patient’s lymph nodes.

There is a simple method of autofluorescent endoscopy for visual assessment, incl. mucous membrane of the oral cavity and ENT organs. The fluorescent stomatoscopy device in the dental office and clinic allows you to identify dysplasia at an early stage, up to malignant neoplasms. The method of autofluorescent endoscopy is used for early diagnosis and screening of diseases of the ENT organs, which are inaccessible to a simple visual examination.

Prevent and defuse

Scientists and doctors believe that cancer is primarily a disease of the genome. But at the same time, only 1% of human genes are associated with carcinogenesis, so experts pay special attention to risk factors.

The development of the oncological process occurs in 5-9 stages – mutations in various oncogenes and anti-oncogenes that stimulate and inhibit tumor development. Precancerous conditions during this period, when the disease is still at the precancerous stage, can be diagnosed not only by oncologists, but also by doctors of various specialties, to whom the patient comes for other reasons.

In the early stages, most oncological pathologies are curable, and many of them can even be prevented. If a person is attentive to his health, undergoes an annual medical examination, and a doctor of any specialization pays attention to the slightest signs of pathology, most patients have a chance not only to overcome the disease, but also to avoid a serious illness.

Primary prevention is especially important, its task is to prevent the development of a malignant neoplasm. According to the World Health Organization (WHO), the main steps towards this are a healthy lifestyle, smoking cessation, prevention of physical inactivity and obesity, and vaccination. These measures reduce the risk of developing pre-cancer diseases and tumor processes.

Secondary prevention is various oncoscreenings that allow diagnosing malignant tumors at the preclinical stage, when nothing bothers the patient. The main effective screening methods: mammography, HPV testing, liquid cytology, gastrocolonoscopy, etc.

Tertiary prevention concerns cancer patients and is aimed at earlier detection of recurrence of the tumor process and prevention of a severe course of the disease. First of all, it is important to quit smoking. However, according to oncologists, the majority of patients with tumors of the oral cavity and larynx, from 50 to 83% of patients with cancer of the upper respiratory and digestive tract continue to smoke after the initial diagnosis. Meanwhile, continued smoking of cigarettes reduces the effectiveness of treatment. Patients who smoke develop conditional resistance to some modern drugs that are used in any treatment strategy. Overall survival rates in smokers are significantly lower than in non-smokers. According to a well-known oncologist, professor, corresponding member of the Russian Academy of Sciences, head of the Department of Clinical Epidemiology of the Research Institute of Clinical Oncology of the Federal State Budgetary Institution “N.N. N.N. Blokhin”, President of the Anticancer Society of Russia David Zaridze, smoking cessation not only improves survival, reduces the risk of postoperative complications, side effects of radiation therapy, increases the effectiveness of chemotherapy, but also improves the quality of life of patients with lung cancer: “In patients who continued smoking after a diagnosis of lung cancer, the mean symptom score was higher than that of quitters.”

How to avoid getting sick

It is not only possible, but necessary, to prevent cancer or to be cured when diagnosed in the early stages. The fight against cancer will be successful if patients and doctors work together. The most important factor in reducing cancer mortality is the responsible attitude of people towards themselves: a healthy lifestyle, smoking cessation, regular preventive screening.

Healthy lifestyle. Proper nutrition low in fat and fast carbohydrates, moderate consumption of red meat and plenty of vegetables, regular physical activity will help get rid of excess weight, ensure good health.

To give up smoking. Doctors are convinced that if people stopped smoking today, the incidence of cancer in general would decrease by about 30%, of which lung cancer would account for the lion’s share. “Up to 80% of patients are not ready to quit smoking immediately, and it is necessary to at least reduce the negative impact of tobacco smoking on the course of malignant pathology and the effectiveness of treatment,” says Associate Professor of the Department of Surgical Dentistry and the FGBOU HE PSPbGMUTs named after A.I. acad. I.P. Pavlova of the Ministry of Health of Russia, oncologist Svetlana Kutukova. — If a person is not ready to quit smoking, we can recommend him to reduce the risks, for example, with the help of tobacco heating systems that are popular today, which minimize the harm of tobacco smoke and carcinogenic tars. In patients who quit smoking, we observe an improvement in biochemical parameters, including those responsible for inflammation, thrombosis, and tissue oxygenation.”

Regular examination. A complete medical examination is required annually. And if there are health problems or ailments for unclear reasons, sudden weight loss, changes and neoplasms on the body, you should not wait until they pass by themselves (this most likely will not happen), you should immediately visit a doctor.

Cancer alertness. It is important that a medical specialist of any profile pays attention not only to the main complaint of the patient, but also to the minimum symptoms that may indicate the presence of oncological disease. This is a direct reason to refer the patient for further examination in order to detect the presence of a malignant neoplasm as early as possible.