Lifestyle and Cancer Prevalence - Aventure - Health & Fitness - Volume 11 / Issue 4 / October 2021

JGI Jain - Aventure - Volume 11 / Issue 4 / October 2021

Lifestyle and Cancer Prevalence

This article is not about conventional cancer prevention guidelines asking readers to abstain from alcohol and tobacco usage; to eat healthy, practice safe sex, ensure regular medical check-ups and screening tests, to get vaccinated, to enhance physical activity, etc. The aim of this article is to raise awareness that genetics and environment are indirect risk factors for cancer.

At the cancer care centre reception area, a display read: “There is a ‘can’ in cancer because we CAN beat it!” Personally, a challenging time, as I sat there anxiously awaiting my parent’s surgery update, even as my aunt was undergoing a chemotherapy session. Beside me sat a lady, equally dishevelled – this disease renders the kith-and-kin to grope around in dark unknown territory, dabble the financial implications, emotional distress, and other factors that precipitate for both patient and caregivers, to desperately aspire for better days.

“Sir, how have you been coping with the situation at home?” she asked.

“I’m taking one day at a time since any form of planning is in vain,” I answered.

“Where do you think we went wrong? Has the air that we breathe and the food we intake become so excruciatingly toxic? Isn’t it unnerving that the numbers of cancer affected are multiplying exponentially?” she asked in grave concern.

“Genes, I believe have a major role to play. Either, the inherited genes are damaged, and/or the polluted environment poses significant risk factors that influence a gene damage to cause mutation is what I’ve heard in general,” was my response.

The ensuing days it prompted me to research a little more and speak to a few medical professionals to gain clarity on this subject. India reported close to 14 lakh cancer cases towards the end of 2020, which is slated to grow at approximately 15 per cent to 15.7 lakhs by 2025. Non-Communicable Diseases (NCDs) accounted for 63 per cent of all deaths in India, of which, quite alarmingly Cancer alone contributed close to 9 per cent.

My daughter is a recent medical graduate who is currently working at a fairly large general hospital. She planned for me to sit down with a group of her doctor friends at the cafeteria to facilitate peer group viewpoints on certain aspects of this topic.

Dr. Prakruthi set the context to her colleagues: “I have always been alarmed at the increase in inflow of cancer diagnosed patients at the hospital. Of course, we have the gene mutations of p53, BRCA 1 and 2, etc. but could it be that the environment has some effect? Our lifestyle habits have changed, smoking and alcohol consumption has become a ‘fad’ even though its detrimental effects are well known. We are exposed to pollution more than before. Sexually transmitted diseases lead to cervical cancer (HPV), liver cancer (Hep C), and so on. I think it’s crucial we understand how to reduce the influence of external factors to minimise our risk of developing cancer.”

Dr. Kumar started out that our genes are the primary factors that shape our health disposition. He said, “Genes play a role in making a person more susceptible or less susceptible to certain diseases.”

This implies that an individual is pre-disposed to various disease conditions. Dominant and recessive genes throw a lot of light on how certain traits are exhibited or not exhibited, and the same holds good for certain health conditions too.

I explained to Dr. Kumar the scenario at the cancer centre and my little chat with the lady. He explained his interest in breast cancer and ensuing research: “The proteins BRCA 1 and 2 are accepted gene testing methods. These proteins are critical to fight breast cancer since they are tumour-suppressor genes. When they work normally, they initiate and manage the growth and division of breast, ovary and other types of cells; however, an uncontrolled cell-growth is an indication of prevalence of cancer. A positive test result is indicative of a gene mutation in one of them to indicate a higher risk to develop breast or ovarian cancer as opposed to someone without mutation.”

With regards to the increased incidence of prostate cancer in men, Dr. Kumar quipped: “PSA (Prostate Specific Antigen) is a protein made by the prostate gland cells and a screening test for prevalence of prostate cancer in men. Elevated PSA levels may indicate a higher risk, and further tests have to be conducted to confirm.” He pointed out that, “Early screening and advancements in genomics, proteomics, bioinformatics, etc. have reduced the risk since they can now catch it sooner, before it plays havoc in the person’s system.” 

At this point I submitted that there could be several e x t r i n s i c factors like lifestyle and e n v i r o n m e n t that influence an individual’s health. I stated that I have read many articles that discuss the detrimental impact of the toxic environment that we live in or are continuously exposed to at work where we spend long hours. Toxic environmental substances that we are exposed to are instrumental in causing a chemical change at the cell-level, and with long term exposure, at the genetic level.

The young doctors in the group helped me to size this problem and get a better picture. Dr. Rohit stated: “The food that we consume today has significantly-reduced nutritional value, more so the junk fast-food. Our fast-paced life headlined as ‘perennial paucity of time’ has everyone scrambling from pillar to post. I don’t have time for home cooking and if I cook a healthy meal at home, it is only because it is my hobby. Food discipline in both quality, quantity and timings has gone kaput and has left a lot to be desired.”

Another young lady, Dr. Roshni commented: “the way we consume the food we eat has a role to play. The usage of aluminium foil to wrap and pack fast-food while still hot, packing hot food in low-grade plastic containers and hot liquid food into very thin bags, frozen food that is thawed and then microwave-heated are ubiquitous practices today. In our country, these are recent happenings accentuated by swift delivery mechanisms which makes it a larger threat due to inconsiderate usage and lack of awareness.”

At which point Dr. Pillai added: “We were discussing with our consultants the case of a patient in his late 60s who was diagnosed with Alzheimer’s disease high concentrations of aluminium were found in his brain tissue.” Certain scientific studies have concluded that altered living conditions associated with society’s industrialized approach to all aspects have made it a modern disease.

The janitor stepped in and sprayed a blue-liquid to clean our table, to disinfect and deodorise. Dr. Kruthi was quick to point out: “Look. cleaning agents are used in almost all walks of life, more so in these Covid times. The ramifications include the usage, which on its own is a threat to safety from long-term exposure. Besides inconsiderate mixing with other agents results in chemical reactions, and any inhalation of those fumes can be hazardous to humans in the long run.” We all thanked Covid pandemic which has necessitated wearing of masks which may help reduce inhalation under such circumstances.

“Carcinogenic substances are in plenty due to increased microwave heating and reheating practices. Increased and abundant usage of deodorants, aerosol sprays, preservatives in packaged food, cosmetics, and many more such examples expose us to bodily harm, may be not in 1-2 instances but from extended long-term exposure,” explained, Dr. Desmukh who opined that social pressure to smell and look good have a role to play.

I stated that common man is aware that smoking and chewing tobacco are known devils and are causing cancer of the mouth, lung, larynx, pharynx, etc. Dr. Rohan qualified the same when he remarked: “A cause for concern is the fact that the consumption of tobacco and a few of its’ other avatars that claim they are tobacco-free, are now pervasive with increased access to remote areas. Due to escalated glamour quotient from celebrity endorsements, its repercussions on a denser population that is both gullible and illiterate make it a larger threat to our society.”

Consumption of alcohol and its ill-effects are now known better due to awareness campaigns. A few doctors hid their snigger when they commented that it contributes heavily to the government coffers, but finally opined that alcohol consumption targets the liver and in the long-term causes cirrhosis and related ailments that can render the immune system vulnerable.

Occupational hazard involving work environment and working conditions is a huge risk factor. Working extensively with asbestos, traffic manning by cops with excessive exposure to vehicle exhaust fumes, cleaning clogged drains and under improper conditions by janitorial personnel, exposure to ionizing radiation and benzene compounds make it a scary proposition.

Dr. Sneha, from the OBGYN department added, “The usage of unhygienic sanitary methods, indiscriminate usage of birth-control pills to postpone pregnancy and extend the child-bearing age are not in themselves conclusive as cancer-causing but should alert an individual to discern and make the right choices.”

No two individuals will respond in the same manner to the same environmental stimulus. A screening schedule and proactive health check-up are not to be ignored; certain disease conditions become complicated due to delayed intervention.

The few external factors discussed above from excessive and continued exposure with lack of screening and pro-active measures make them an indirect cause to this dreaded disease. These factors lead to cardio-vascular or nervous or renal or excretory system abnormalities giving rise to a compromised immune-structure to cause the ageing human body be more susceptible to risk factors.

The current Covid-induced pandemic is a case-in-point. Many covid positive patients have reported increased susceptibility to various other diseases from lower immunity levels. Few other cases has reported that cancer patients as well as people with chronic illnesses postponed their treatment leading to further complications. My aunt, that I so passionately addressed at the start of this article, lost her battle last year during the Covid lockdown period. Reduced mobility resulted in a fast deterioration of her health and the disease made a rapid spread to all her internal organs at a pace that made any delayed medical intervention a futile exercise.

Whether it is internal or external, it is the gene and modification referred to as gene mutation that causes increased risk of cancer incidences. With our population here in India growing at an alarming pace, the absolute numbers will numb the brains and render the society motionless. Tell-tale signs are evident in this part of the world and our country has the dubious distinction as the ‘diabetes capital of the world / the cardio-vascular hotbed’ and so on to make cancer management even more challenging.

Cancer incidences have grown too, the proof is in the pudding. More and more cancer hospitals are popping up, somewhere within each family a member has been diagnosed, and within distant but known circles a death has resulted from cancer. An optimistic view is we each know a cancer survivor amidst us. Sanity should prevail above stupidity to alert us that the perpetrator is indeed a known enemy.

It is one thing to win over cancer with so many efficacious treatment options due to scientific advancements, but it’s another thing to pro-actively manage the self while being aware of a plethora of influencers. Taking quick course corrections to the diet, exercise regimen, and lifestyle changes in order to ward-off the dreaded 6-letter word is a prudent decision. How many of us can bring about a change in the way we understand the ill-effects of the external stimuli to lessen their consumption in quantity as well as frequency? How many of us can be the evangelists to assume courage and call ‘a spade a spade’ to manage narratives within our circle of influence? How can we endeavour to the good cause of education through awareness campaigns at our own individual levels to make the “CAN” in the opening paragraph a reality?

Dr. Anil Kumar as head of the department at a leading Bangalore-city teaching hospital commented: “Lifestyle measures have a definite role in cancer prevention. Many cancers are treatable, and a positive attitude too helps in defeating cancer.”

Michael Douglas the popular Hollywood star remarked, “Cancer didn’t bring me to my knees, it brought me TO MY FEET.” Time is of essence, and we need to think on our feet to collaborate and embark on a few lifestyle changes now rather than regret later.