Prevention of Cancer – 9 – Breast Cancer 2

                                            Prevention of Cancer PART – 9
(All the articles published in past are available at www.shyamhemoncclinic.com/blog/)
Question: In last part, we discussed some very important points. Doctors as brand ambassadors for Healthy Lifestyle. Night shift increases risk for breast cancer, digestive system cancers and lung cancer. On the contrary, being a morning person reduces risk of breast cancer. No amount of alcohol is safe, including wine. And how even wine increases risk of breast cancer for women. Additionally, alcohol increases risk of several cancers i.e. colon, rectum, liver, esophagus, and most importantly head and neck cancers as we all know. Smoking independently increases risk of breast cancer too, even without alcohol use. And when combined with alcohol, smoking increases risk of several cancers manifold especially head and neck cancers. Once again, if these risk factors started at a younger age, before first childbirth, risk is significantly higher.
Most breast cancers are in fact not due to bad genes, but due to acquired factors. Can you elaborate more on this last point, as most patients ask us this question. That they have no family member with breast cancer and yet why did they develop it? Same question for other cancer types too.
Ans: Yes. Like I mentioned last time, only about 5-10% cancers are truly hereditary. That means related to an identifiable genetic mutation. For all others, it is acquired risk factors. Some of these acquired factors we do know like tobacco, alcohol, lifestyle, various chemicals and others. And many others we do not know.
Now for some cancers, even without an identifiable mutation, there is a tendency to develop cancers in the family. For example, multiple family members with breast cancer, or other different types of cancers. Most of these develop at older age, after 50-60 for example. Genetic tests turn out to be normal. These people may have some constellation of genes that make family members susceptible. But the expression of those genes is largely controlled by acquired factors. Lifestyle changes is one of those important factors that decides whether a marginally bad gene will be allowed to turn into a cancer or not. Same applies for family history of heart disease for example or diabetes. If a healthy lifestyle is followed, from an early age especially, risk of these diseases reduces significantly.
Que: You have brought out a very important point. This explains why many families have tendency for cancers, or heart disease in some etc. And also explains why all smokers don’t have same diseases for example. One person who smokes tobacco develops lung cancer for example, another one heart attack, another one emphysema….Even though risk factor is same, complication is different. This is due to tendency governed by genes I suppose.
Ans: Yes. And that is why overall healthy lifestyle is the answer to prevention of most common diseases. Today many people get genetic profiles done. For several thousand rupees, one can obtain a profile of all genes. It comes with a report suggesting “you are at risk of developing so and so diseases, cancers etc”. The report does not mean gurantee of developing these diseases NOR does it mean guaranteed safety from other diseases not mentioned in the report. Bottomline is it would still recommend no tobacco, no alcohol, exercise, healthy diet, healthy lifestyle etc. Going through such a report will make most people anxious for many months or rest of their life, that they are at risk of developing a cancer, heart attack etc. Very few people can actually handle such information and use it positively to improve their health.
Que: Holistic Health as you have mentioned earlier. Focus on health as a whole, not as individual diseases.
Ans: Additionally, many cancers that run in the family are also due to same acquired risk factors, same lifestyle. For example, use of tobacco, alcohol, diet, sedentary lifestyle, other habits such as poor hygiene etc. These can be addressed by family doctors. Many a times, pointing out potential risk factors by family doctor can help people change, especially after a recent diagnosis of cancer in a family member.
Que: Very important role of family doctor there in cancer prevention. I notice you have mentioned poor hygiene as a risk factor for cancer. Is this true, or you are only referring to good habits in general?
Ans: Good observation. Hygiene is certainly linked to cancer in several ways. Large epidemiologic studies mentioned earlier, such as Women’s Health Initiative, and several other studies, including those from world’s top public health schools like Johns Hopkins, have identified Oral Dental hygiene as an important risk factor.
                                        Yes, Clean Mouth Teeth Gums prevent cancer!!!
Not only cancer, dental hygiene is also linked to heart diseases, stroke, and other diseases too!!!
This comes as a big surprise to most people. But this is a consistent finding. And risk is increased for not only Oral cancer, but also for Breast, Lung, Colon, Esophagus, Melanoma, and possibly stomach. This is even a bigger surprise. How can this happen??? Well, there are multiple theories. One is persistent inflammation due to persistent infection. Additionally, periodontal pathogens have been found in precancer and cancer lesions both. And these are known to promote procarcinogenic microenvironment. Similarly there is data about heart disease, stroke, metabolic disorders, rheumatoid arthritis etc. Once again, pointing to importance of HOLISTIC HEALTH. Let us talk more about Hygiene next time – an easily modifiable risk factor!!!
September 3, 2022

Dr Chirag A. Shah; M.D. Oncology/Hematology (USA), 9998084001. Diplomate American Board of Oncology and Hematology. Ahmedabad. drchiragashah@gmail.com