Anne McTiernan
In his State of the Union address, President Obama announced a “moonshot” program to fight cancer. In charge of that program, Vice President Biden has met with oncologists, scientists, and other leaders in the cancer field, and stated that, “We’re trying to get to a quantum leap on the path to a cure”
Anne McTiernan MD, PhD.
Much of the focus has been on Big Data, and on sharing science across institutions, in the effort to quickly move results from the lab to the public. In a nation where approximately four in ten people can expect to be diagnosed with invasive cancer in their lifetimes, we need big efforts to fight this disease.
Today, World Cancer Day, is a time to raise awareness of prevention: Cancer prevention needs to be a part of the renewed push against cancer.
Focusing only on the cure is like trying to douse a forest fire on one front while someone is lighting matches on another. The good news is that we already have the knowledge and tools here on earth to prevent a large proportion of cancers from developing, without reaching for the moon.
Avoidance of known carcinogens (including tobacco, excess radiation, sun and tanning), and use of vaccines for human papilloma and hepatitis B viruses, can prevent a wide range of cancers such as lung, skin, liver, cervix, mouth and throat. Screening and removal of premalignant lesions can prevent several cancers including those of the skin, colon, and cervix. Medications have been shown in clinical trials to prevent breast or prostate cancers in persons at high risk for those cancers.
Researchers have also identified diet and physical activity as key components of cancer prevention. More than a third of cancers could be prevented if people avoided becoming overweight or obese, maintained recommended levels of physical activity, ate a nutritious diet, and avoided excess alcohol consumption.
Specifically, the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) recommend that people keep their body mass index in the normal range, eat a diet high in vegetables and fruits and low in refined sugars and meats, and perform a minimum of 30 minutes a day of moderate intensity physical activity. They further recommend that men drink no more than two alcohol drinks per day on average, and that women limit their alcohol consumption to an average of one alcohol drink per day or less.
There is still need for research in all of these areas of cancer prevention. AICR and WCRF are leading efforts to determine the roles of diet, physical activity, and overweight on cancer prevention and on prognosis in persons with cancer. We don’t yet know if weight loss can prevent cancer or improve survival, We don’t yet know if weight loss can prevent cancer or improve survival, nor can we personalize the optimal diet for cancer protection. We can’t yet provide individualized cancer-fighting exercise prescriptions. We don’t yet have the ability to motivate the entire population to follow the lifestyle recommendations.
In spite of the unknowns, we do have enough information to give hope to the millions of individuals at risk for cancer or who are living with cancer, that there are things they can do now to lower their risk and to improve their health.
Anne McTiernan MD, PhD, is at the Fred Hutchinson Cancer Research Center. Her research focus is the prevention of new and recurrent breast and other cancer through physical activity, diet and chemoprevention.
