Lifestyle Medicine vs. Cancer

An illness may result in the loss of something of greatest value, namely some aspect of one’s health.  When considering cancer, you may think “I am at risk of losing my health and there is nothing to be done about it.”  But, is this really true?  According to research by Mingyang Song, MD, ScD and Edward Giovannucci, MD, ScD, “about 20-40% of cancer cases and about half of cancer deaths can be potentially prevented through lifestyle modification.”1  Yet, individuals continue to believe there is nothing preventative to be done under the mistaken notion that cancer is about non-modifiable—“nothing I can do about them”–risk factors such as genetics, age, or race.

Enter the good news, Lifestyle Medicine has evidence-based information on modifiable risk factors and the actions you can take to help counter them:

What you put in or on your body, and what you do for your body.

Someone is already thinking, “If that were true, then why do picture-of-heath individuals get cancer”?  Generally speaking, information about disease and its etiology, complications, etc., fill medical school libraries and is profoundly beyond the scope of this article.  Further, certain details of an individual’s life, e.g., childhood and workplace environmental exposures, may never be known and therefore impossible to factor into the individual’s equation.   However, it is generally agreed that 40% of cancer diagnoses are preventable with changes to lifestyle.  Before you write off lifestyle consider the following: 

EXPOSURE

Smoking has long been linked to lung cancer, sun exposure to melanoma, radiation to thyroid cancer, and Human Papilloma Virus (HPV) to cervical and other cancers.  And, have you seen the legal advertisements on TV with regard to asbestos exposure and Mesothelioma?  Most of us are aware of at least some cancer/exposure links.  Lesser known associations include alcohol’s link with six different kinds of cancer.  Another is Diethylstilbestrol (DES), a synthetic estrogen used during pregnancy between 1940-1971, which resulted in cancer in some of these women and their offspring.  Studies are now ongoing in their grandchildren.  So, the message here is avoidance of exposure to limit your risks.

IMMUNITY

White Blood Cells Attacking an Invader

Think of the immune system as your body’s own little army of “soldiers.”  A “foreign invader” such as bacteria, a virus, or even an abnormal cell forming inside the body sends the “soldiers” into action to prevent invasion, replication and dispersion.  But, as with certain illnesses like HIV/AIDS, impairment of the immune system can occur.  Transplant recipients require immunosuppressive medication to prevent the “soldier” cells from mistakenly attacking the new organ.  These “soldiers” also may not be able to destroy unrelated cancer-causing infections or cancer cells, hence the restrictions placed upon these patients regarding crowd exposure, etc.

INFLAMMATION

When an injury occurs, the body’s immune system sends white blood cells and chemicals to heal the area.  This will present as a warm, red area around the wound.  However, sometimes after the injury is healed, the inflammation remains.  It is even possible to have inflammation without an injury or infection; this chronic inflammation can damage healthy cells and weaken the immune system, leading to development and growth of cancer cells.

EXAMPLES FROM EACH OF THREE AREAS

Viruses, bacteria, and parasites are all part of the problem.  By exposure, they enter the body.  Some disrupt the cell communications; others weaken the immune system, decreasing the body’s ability to defend itself against other cancer-causing infections; and a few lead to chronic inflammation.  Some like H. pylori (best known as causing stomach ulcers) and Hepatitis C have treatments available.  Others such as Hepatitis B and HPV have vaccines available for prevention before exposure.  Your doctor will guide you regarding appropriateness of vaccines for yourself and your family.  When traveling, educate yourself about the geographic area and the preventive measures you can take to reduce exposure to pathogens.

SO, HOW TO AFFECT THESE AREAS

Every time you eat, it is an opportunity to put something into your body to make it function better.  Does this mean supplements?  No, real food!  Blueberries for example, are showing amazing potential in studies to not only prevent cancer from forming but to assist in cancer therapy by making the cancer cell more susceptible to treatment.  To see other ways foods can positively affect your health refer to the “The Nutrition Rainbow2.

So, what else can I do?  Shown below are other activities you can incorporate and their cancer-busting potential.

Hopefully, this article has given you a brief introduction to the relationship between lifestyle changes and their ability to perhaps lessen potential cancer risks, all presented in a way that is understandable to those not seated at the science nerd table.  Or, maybe you are still caught up in the “this is too much trouble; this is too unlikely; this is not do-able in a family of five; this isn’t going to mitigate the strong history of “x” cancer in my family,” etc. But, you read the article…all the way to the end.

In a nutshell, Motivational Interviewing, a counseling technique, defines five stages of change:

  • Pre-contemplation—“Leave me alone.”
  • Contemplation—“I’m thinking about it, but on the fence.”
  • Preparation—“I’m going to do it.”
  • Action—Do it.
  • Maintenance—Ongoing monitoring.

Remember, you read the article…all the way to the end, so you may well be at Stage 2 or even 3.  Continue to digest the information and maybe even look up some additional sources online or chat with your primary care doctor or Lifestyle Medicine physician.  Should you undertake to make changes, remember perfection isn’t expected or being broadcast on social media.  Any change, however small, you undertake to promote better health can only help.

References:

  1. Song M and Giovannucci E. JAMA Oncol. 2016;doi:10.1001/jamaoncol.2016.0843.
  2. “The Nutrition Rainbow” by The Physician’s Committee for Responsible Medicine. Link

Lifestyle Medicine

Reprint of my article as printed in Inside Medicine magazine August 2018 edition.

The old expression–”there is nothing new under the sun”— may indeed be true.   But, old ideas sometimes can be explained in a new way.

Many people are already aware that their habits can affect their health.  The news is full of “don’t eat this,” or a new study on exercise.  And, yet, we as a nation appear to be getting sicker.  It is difficult for doctors to discuss health given our current illness-based insurance model.  With genuinely caring physicians having such limited time with each patient, the recommendation for a one-size-fits-all diet and exercise approach is often the norm.

Fortunately, out of established research a new branch of medicine has emerged with the focus on helping people improve their health and prevent chronic diseases.  Based on improving six areas of health, Lifestyle Medicine uses many non-drug modalities to treat, improve, and sometimes even reverse chronic health conditions. Medication, while still used, becomes the supplement to these lifestyle changes.

These six areas are:

  1. Nutrition—getting vitamins, minerals, protein, fiber, phytonutrients, etc., from a predominately whole-food, plant-based diet
  2. Movement—consistent daily movement that works all the muscles, including the heart
  3. Sleep—improving the quality of rest
  4. Substance use—eliminating the use of tobacco and other potentially harmful substances
  5. Relationships—establishing and nurturing supportive social connections
  6. Stress management—leading to improved health and productivity

Why focus on so many things? In addition to the fact that individually each of these areas can produce health issues (e.g., tobacco and cancer), they also can affect each other. Improved sleep may assist in weight loss.  Moving may reduce stress. And, if you don’t fuel your body with a good quality diet, it’s little wonder you don’t feel like getting off the couch.

Would you like to feel better about your health? The process starts by deciding what your goal is and perhaps even writing it down.  Maybe you would like to run a 5K or simply be able to play on the floor with your grandchildren.  Next is to identify areas you are willing to change.  Maybe the coffee creamer will not be eliminated, but you will eat an extra serving of a green vegetable each day.   An earlier bedtime is not feasible, but you are willing to encourage deeper sleep by turning off your phone and leaving it in the kitchen overnight. Successes are celebrated and failures are put to good use as you learnto analyze, re-adjust, and overcome.

So, while the message is not new—your mother may have told you to eat your vegetables and get plenty of sleep—life has a way of intervening and sending us down another path.  Now is the time to learn how to manage that stress, get some quality rest, develop a strong emotional support system, avoid substance use, and become active while being mindful of your food choices.  It may just be exactly what the doctor ordered!

Elizabeth McCleskey, DO Board Certified Family and Lifestyle Medicine; Member, American College of Lifestyle Medicine; HealthStylesDr.com