World Cancer Day written by Miriam Schlisselfeld, Student at University of Alabama.

Edited by Andrea Polvere, MS Student at Pace University

In the United States, cancer is the second leading cause of death CITATION Fac \l 1033  (Facts about Cancer, n.d.). This devastating disease effected 10 million people in 2020 alone, with the most prevalent type being breast cancer, followed by prostate and lung cancer (Common cancer types, n.d.; Leading Causes of Death, 2022;) There are a number of risk factors that correspond with an individual’s likelihood of developing cancer such as older age, genetic predisposition, obesity or overweight, alcohol consumption or tobacco use (Understanding cancer risk, 2022).

Due to its widespread implications, the Union for International Cancer Control (UICC) created a global initiative called World Cancer Day at the 2000 World Summit Against Cancer for the New Millennium in Paris. This campaign, marked on February 4^th, aims to raise awareness, improve education and research, improve patient services, and encourage early prevention, detection, and treatment (Our Story, n.d.). World Cancer Day’s impact is seemingly endless, with over 24,000 press articles in 160 countries, 980 total events in 105 countries, over 327,000 social media mentions, and 75 active governments!

Each year around the world, hundreds of events take place in an assortment of communities such as schools, businesses, hospitals, community centers, and more in acknowledgement of World Cancer Day! It is characterized by events and activities that range from creating customizable social media posters, partaking in the 5k challenge, making donations, attending, volunteering, or participating in a local event, or even creating your own event! This year, two local events took place within the New York metropolitan area: Black Women in Oncology against Cancer in New York, New York, and Rutgers World Cancer Day Recognition Event in New Brunswick, New Jersey. Check out the World Cancer Day website to see what you missed this year and to explore other opportunities you can become involved with.

Although there is no guaranteed prevention for cancer, there are several lifestyle factors within your control that can be used to protect against the risk for development.

Maintain a Healthy Weight

In a meta-analysis conducted by the World Cancer Research Fund (WCRF)/ American Institute for Cancer Research (AICR), there is evidence that having extra fat mass significantly increases the risk of several cancers, including but not limited to breast (post-menopause), mouth, stomach, pancreatic, liver, kidney, and prostate cancers (Obesity, weight gain and cancer risk, 2022). An increase in fat, or adipose, tissue leads to prolonged inflammation within the body, which creates an environment conducive to insulin-resistance. Insulin resistance, which is the body’s inability to properly respond to insulin, can trigger an increase in the number of cells produced, as well as make sex hormones, such as estrogen, more readily available. Both of these results can increase cancer risk (Underferth, 2020).

Extra fat mass can be marked by several factors, such as high body mass index (BMI), which is considered above 25. However, BMI is not a precise indicator of body mass as it does not take into account the fat mass versus muscle mass. Additional measures, such as waist circumference and waist-to-hip ratio, tend to be more illuminating and have been found to be correlated with extra fat mass. Each 4-inch increase in waist circumference was shown to increase the risk of various cancers as follows: esophageal adenocarcinoma by 34%, pancreatic cancer by 11%, postmenopausal breast cancer by 11%, kidney cancer by 11%, endometrial cancer by 5%, and colorectal cancer by 2% (Preventing Cancer, 2021).

Awareness and self-accountability is the first, imperative step in the process of prevention as it pertains to weight. A biannual visit to your primary care physician or healthcare professional is recommended to ensure you are maintaining a healthy weight.

Participate in Physical Activity

Physical activity, as defined by the World Health Organization, is the utilization of skeletal muscles to produce any type of movement, requiring an increased amount of energy expenditure. Aerobic exercise, meaning “with oxygen”, is any type of cardiovascular exercise and ranges from mild, moderate, or vigorous. Some examples of aerobic exercise include brisk walking, biking, running, dancing, yard work, rowing, or swimming. On the other hand, anaerobic exercise means cellular respiration occurs without oxygen. Anaerobic exercise includes strength training activities like free weights and weight lifting, HIIT exercises, and yoga or Pilates. Due to the weight loss properties resulting from both types of exercise, a balance between both may play a role in preventing cancer.

During a 2022 meta-analysis and umbrella review, sedentary reviews were analyzed with risk of several cancers such as endometrial, colon, and lung (Hermelink, et al., 2022).  The study defined sedentary behavior as occupational and recreational sitting, as well as TV-viewing time. It was found adults around the world spend an average of 8.2 hours sitting per day. As a result, the highest versus lowest levels of sedentary time increased risks of these cancers by a statistically significant range of 20-35%.

Exercise can be found in every facet of life, not just in the gym. Getting into the habit of increasing your physical activity starts with small, daily changes that will improve your body and mindset. Here are some small suggestions for increasing your physical activity without needing to change into workout clothes:

• ·       Walk around your neighborhood.
• ·       Park your car further in the parking lot.
• ·       Take the stairs instead of the elevator.
• ·       Use light hand weights during commercial breaks while watching television.

Eat a Well-balanced, Healthy Diet

An overall healthy diet, modeled after MyPlate, has the potential to lower all cancer risk by 10-20%. (Preventing Cancer, 2021). This Healthy Eating Plate graphic showcases the following recommended proportions: ½ plate fruits and vegetables, ¼ plate whole grains, ¼ plate lean protein, and healthy oils in moderation. Furthermore, fruits and vegetables should be versatile in color and variety, with an emphasis on non-starchy vegetables. As for whole grains, some examples include whole wheat, barley, wheat berries, quinoa, oats, and brown rice. Similar to fruits and vegetables, protein sources should be versatile in type. Plus, red meats and processed meats, like bacon and sausage, should be avoided. Lastly, some healthy oil options include olive, soy, corn, sunflower, safflower, avocado, flaxseed, walnut, and others.

There is strong evidence that eating whole grains protects against colorectal cancer. More so, dietary fiber has been found to protect against colorectal cancer, weight gain, overweight, and obesity  CITATION Pre21 \l 1033 (Preventing Cancer, 2021). There are several mechanisms from components found in whole grains that may play a part in these protective properties (Slavin, 2000):

• ·       Fermentation of complex carbohydrates in the colon results in short chain fatty acids (SCFA) production, inhibiting cell growth and migration, as well as inducing apoptosis in cells, such as cancer cells (Mirzaei, et al., 2021).
• ·       Antioxidants, including trace minerals and phenolic compounds, act to “enhance the body's immune system to recognize and destroy cancer cells and to inhibit the development of new blood vessels (angiogenesis) that is necessary for tumor growth” (Newmark, 1996).
• ·       Phytoestrogens, found widely in whole grains, exhibit antioxidant, anti-inflammatory, and anti-thrombotic properties. They have a similar structure to estrogen, which allows them to bind to estrogen binders and interfere with hormonal signaling. Phytoestrogens are especially important in the prevention of hormone-dependent cancers like breast and prostate.

Below are some dietary guidelines and recommendations to achieve a more healthful diet to combat the development of various cancers:

• ·       Adults should consume at least three 16-gram servings of whole-grain foods daily.
• ·       Consume 25 to 30 grams of fiber per day.
• ·       Opt for lean protein options whenever possible– that includes fish, poultry, eggs, beans, peas, lentils, nuts and nut butters.
• ·       Limit alcohol consumption
• o   Men should limit themselves to 2 drinks or less per day
• o   Women should limit themselves to 1 drink or less per day
• ·       Restrict “fast foods”, prepackaged foods, and eating out at restaurants whenever possible. These foods tend to contain high amounts of saturated fats and/or sodium.
• ·       Limit sugar-sweetened beverages like juices and sodas as much as possible.

References

Common cancer types. National Cancer Institute. (n.d.). Retrieved from https://www.cancer.gov/types/common-cancers#:~:text=The%20most%20common%20type%20of,are%20combined%20for%20the%20list

Facts about Cancer. (n.d.). Retrieved from World Cancer Day https://www.worldcancerday.org/materials?f%5B0%5D=category%3A8&f%5B1%5D=language%3Aen&f%5B2%5D=language%3Aen

Hermelink, R., Leitzmann, M. F., Markozannes, G., Tsilidis, K., Pukrop, T., Berger, F., Baurecht, H., & Jochem, C. (2022). Sedentary behavior and cancer–an umbrella review and meta-analysis. European Journal of Epidemiology, 37(5), 447–460. https://doi.org/10.1007/s10654-022-00873-6

Leading Causes of Death. (2022, September 6). Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Mirzaei, R., Afaghi, A., Babakhani, S., Sohrabi, M. R., Hosseini-Fard, S. R., Babolhavaeji, K., Khani Ali Akbari, S., Yousefimashouf, R., & Karampoor, S. (2021). Role of microbiota-derived short-chain fatty acids in cancer development and prevention. Biomedicine & Pharmacotherapy, 139, 111619. https://doi.org/10.1016/j.biopha.2021.111619

Newmark, H. L. (1996). Plant Phenolics as potential cancer prevention agents. Advances in Experimental Medicine and Biology, 25–34. https://doi.org/10.1007/978-1-4613-0399-2_3

Preventing Cancer. (2021, March). Retrieved from Harvard TH Chan - School of Public Health: https://www.hsph.harvard.edu/nutritionsource/cancer/preventing-cancer/ 

 Obesity, weight gain and cancer risk. WCRF International. (2022, April 28). Retrieved from https://www.wcrf.org/diet-activity-and-cancer/risk-factors/obesity-weight-gain-and-cancer/

Underferth, D. (2020, May 8). How does obesity cause cancer? MD Anderson Cancer Center. Retrieved from https://www.mdanderson.org/publications/focused-on-health/how-does-obesity-cause-cancer.h27Z1591413.html

Understanding cancer risk. Cancer.Net. (2022, January 28). Retrieved from https://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/understanding-cancer-risk