Cancer

Environmental factors are as important as genetic factors among the causes of cancer. Environmental factors include our lifestyle (smoking, alcohol consumption, eating pattern) and other factors such as air and environmental pollution.

While measures can be taken against some of these factors, others are unchangeable. Family history of cancer, genetic inheritance, certain ages and prevalence in men and women are amongst the unchangeable factors.

However, a healthy lifestyle may help prevention of certain cancers. For example, factors that affect health, such as smoking, alcohol consumption, healthy diet, regular exercise and obesity, should be controlled. Healthy eating, weight loss and healthy lifestyle may reduce risk of cancer by 30-35 percent.

In addition to lifestyle changes, it is necessary to be screened in early diagnosis programs, even if there is no sign of cancer or complaint. Early diagnosis screening such as mammography, prostate cancer screening and HPV test increases the success rate of treatment up to 90 percent in cancer.

Minor changes in your daily lifestyle can be a source of prevention against risk of cancer.

Sun Protection

Of course, sun rays have benefits for our body, but uncontrolled exposure to sun light is harmful. Therefore, try to avoid direct exposure to sunlight from 10:00 to 15:00 in summer and the same applies to your children.

Recurrent sunburns especially in childhood increases the risk of future skin cancer, called melanoma. Do not have long sunbathes in seaside or pool side and use sunscreens with high protection factor half an hour before the exposure to sunlight to protect your skin.

Be Aware of Effects

Our country is rich in terms of sunlight. In addition to benefits, ultraviolet (UV) lights reaching to surface of Earth have non-negligible harms for human beings.

It has played a role in initiation of all biological events in the world, enables synthesis of Vitamin D in our body, helps destruction of harmful microorganisms and has positive effects in human psychology and all our vital activities. In addition, UV light can cause acute and chronic side effects.

Skin burns, sunstroke and photo-allergic reactions are among acute effects. Chronic harmful effects are skin cancers, thinning of skin over time, loss of elasticity (wrinkles), dryness, prominent capillaries, skin spots, freckles, roughening, aging of skin and suppression of immune system.

These harmful effects have been discovered long time ago in clinical human and animal studies. These side effects also apply to artificial UV sources such as solarium. Since artificial UV rays can be generated in all seasons of the year and UV rays are delivered more intensely in a shorter period of time, solarium poses higher risk compared to sunrays.

Who Are At Risk of Skin Cancer?

Prevalence of skin cancer is very high for people who are exposed to sunlight for a long time or intermittently, but more intensely. Other risk groups for skin cancer are as follows:

• Risk of malignant melanoma is higher for people who have light skin tone, light eye color, red-yellow hair or who are prone to sunburn comparing to other people.
• The risk is very high for people who are exposed to sunlight for a long time or intermittently, but more intensely.
• People with family history of malignant melanoma are at twice higher risk comparing to general population.
• Risk also increases in people with abnormal dysplastic nevus syndrome.

People Working Outdoors Should Be Careful

People with light skin color are more sensitive to sunlight comparing to people with darker skin tone. This fact explains why skin cancers are 15 times more common among white race than black race. Moreover, risk of skin cancer is higher for people who work outdoors, such as farmers and sailors.

Sun Protection Is Necessary Both In Summer and Winter

UVA and UVB are within the spectrum of sunlight that reaches the earth. Certain factors increase or reduce the dose of these rays reaching to skin. These include certain hours of day, seasons, geographic regions, density of clouds, altitude and environments that reflect lights.

In our country, 60% of UV lights reach the surface from 11:00 to 15:00. UV rays have maximum effects on the equator, while the effect is minimized towards the poles. Clouds can block approximately 50 % of UV rays. Effects of UV increase in each 300-meter increment of altitude.

UV energy is higher especially in mountainous regions. Snow reflects the UVA by 50-95 percent, water by 5 percent, grass by 3 percent and sand by 5 percent. UVA rays are effective throughout the year without any change at different hours of day, different seasons or weather conditions. UVB rays have stronger effect in summer and at high altitudes. UVB can directly damage tissues, but UVB only harms through photoproducts.

It has been long considered that UVB rays were responsible for skin aging and cancer, but recent research revealed out that both UVA and UVB are responsible for these two conditions. Therefore, sun protection is necessary both in summer and winter. People with light skin tone and children younger than 3 are more vulnerable to adverse effects of sun rays.

Avoid Direct Sun Exposure

Darkening of skin color (sun tanning) is, in fact, a mechanism of body defense to protect human organism against harmful effects of sun.

In other words, when we are exposed to UV rays, our skin activates the defense mechanism, make pigment cells migrate to upper layers of skin and form a protective curtain on the skin.

Direct exposure to sunlight is not recommended. No matter how much a person tries to avoid sunlight, he/she is exposed to sun rays that are enough to meet needs for vital activities both in summer and winter. Therefore, extra sunbathing is not necessary.

Since the ozone layer of atmosphere that filters the sunlight, negative effects of sun rays are, now, stronger than ever. Brown spots caused by sun exposure become more likely due to genetic features, hormonal activities and some foods and drugs (some hormone drugs, oral contraceptives, certain antibiotics etc.)

Therefore, hormonal pattern, medications and eating pattern of the person should be reviewed, if development of brown spots boosts. Freckles are skin spots that are subject to genetic predisposition. However, sunlight aggravates them. There are some allergic reactions triggered by sun.

This phototoxic reaction is related to person’s allergic sensitivity. Moreover, chemical substances exposed from skin surface or taken from mouth can also trigger this reaction. In the light of this information, it is obvious that sun protection should be a part of lifestyle.

Which Sunscreens Should Be Preferred?

For daily use, sunscreen creams should be applied on exposed parts of body, face, ears, neck, décolleté and hands. Sunscreen products that provide protection against both UVA and UVB should be preferred.

Women should apply sunscreen before make-up in summer. Moisturizers that contain sun protection factors are not widely recommended, as the sun protection factors contained in moisturizers may not function properly. Instead, sunscreens that contain a moisturizer base should be preferred.

Moreover, you should wear hat and eyeglasses in summer. Light colored, protective clothes are recommended to avoid sun. Wearing hats with wide sides and sunglasses are very beneficial especially for people with light skin tone.

Be Careful Against These!

Have your skin checked regularly and ask for help of a family member, if necessary. Inspect your trunk, arms and legs, palms and soles on a monthly basis. Check your scalp and back with mirror.

To protect your skin, check the expiry dates of cosmetic products. Expiry dates are written on products so as to prevent damages to our skin after they spoil. If there is no expiry date on a product you buy, remember that their shelf life is 3 years. Note that this time shortens if they are stored in warm environments,

If hormone drugs, antibiotics, antihypertensive agents, cholesterol lowering drugs, medications used for diabetes mellitus and painkillers increase sun sensitivity, you should contact your doctor about potential measures that can be taken.

Cessation of Smoking

Smoking is one of the leading causes of many health problems, most remarkably cancer and heart and lung diseases. Five million people around the world and more than 100 thousand in Turkey - one in every 4 people – die due to tobacco use. It is estimated that the figure will be 240 thousand in 2030.

Smoking accounts for 35% of all cancer deaths in men and 15% in women. Smoking is the underlying cause in 90% of deaths secondary to lung cancer. Since lung cancer correlates directly with smoking, it is the leading cause of cancer deaths.

Smoking is also the pioneering cause of respiratory tract diseases that are manifested by shortness of breath (dyspnea) such as chronic bronchitis and emphysema. People who die due to these diseases are 40 times more than non-smokers. Smoking increases risk of cerebrovascular diseases and stroke through its effects on bloodstream and blood vessels and moreover, it can lead to gangrene in legs.

What are Diseases That Smoking Increases the Risk?

There is a direct correlation between nicotine addiction and several types of cancer. Smoking increases risk of throat, prostate, gingival, mouth, urinary bladder, esophageal, tongue, pancreatic, tonsil and cervical cancers, although the risk is more prominent for lung cancer.

Moreover, it causes other problems in both genders, including impotence, stroke, ulcer, chronic bronchitis, vascular diseases in legs and heart attack in men and infertility and COPD in women. Risk of lung cancer for smokers depends on the time since onset of smoking and number of cigarettes smoked per year. The risk is paramount for those who have been smoking for more than 20 years. The risk cannot be reduced to the level of those who has never smoked, if a person has been smoking for more than 20 years. On the other hand, each extra year of smoking increases the risk further.

What Changes in Our Body When Smoking is Quit?

• Blood pressure and pulse are normalized and blood circulation improves in hands and feet after 20 minutes.
• Blood oxygen saturation is normalized and risk of heart attack decreases after 8 hours.
• Carbon monoxide completely leaves the body after 24 hours.
• Nicotine level in blood decreases, sense of smell and taste normalizes, response to treatment of peptic ulcer improves after 48 hours.
• Breathing becomes easier thanks to relaxation of airways, amount of secretion increases secondary to better functioning in airways 72 hours later; airways start cleansing themselves. The person becomes more energetic.
• Blood circulation improves in whole body, risk of respiratory tract infections decreases and exercise capacity increases after 2 to 12 weeks.
• Respiratory tract problems, such as cough, short breaths and wheezing, disappear and respiratory functions increase by 5 to 10 percent after 3 to 9 months.
• Risk of coronary heart diseases decreases by half 12 months later.
• Risk of bladder tumor decreases by 50 percent 12-36 months later.
• Risk of heart attack and esophageal and mouth cavity cancers decreases by 50 percent 5 years later.
• Risk of heart attack is reduced to the level of those who has never smoked and risk of lung cancer decreases by 50 percent compared to smokers 10 to 15 years later.
• Quitting smoking also has positive effect on social life.

Besides improved overall health, quitting smoking also has positive effects on social life. First, sense of taste from food and sense of smell improve. Constant financial burden of smoking is eliminated.

The air inhaled in close spaces, such as home and car, becomes cleaner. Negative effects of smoking on babies and children are eliminated. Quitting smoking affects sex life positively. In addition, symptoms of withdrawal and anxiety caused by the addiction disappear and the person feels physically more energetic.

Novel Treatment Modalities to Quit Smoking

Being decisive and strong-minded in the first step that should be taken to quit smoking. However, one may need help while liberating from a long-term addiction. There are several treatment options to quit smoking. They include but are not limited to medication and replacement treatments.

Medication Treatment

Quitting smoking is more difficult for certain people due to genetic predisposition that adds to the addiction. The medication represses sensation of urge to smoke. These medications can be prescribed for people who have difficulty quitting smoking.

Replacement Therapies

Nicotine is supplemented by nicotine patches. There are also nicotine gums and even nicotine sprays. There are mentholated smoking mouthpieces as well. However, nicotine patches has to be replaced daily and removed at nights.

These patches come in various doses. Higher dose is prescribed, if addiction is severe. This method can also be combined with medication therapy. Combined treatments are recommended for efficiency. Medication, nicotine patches and nicotine chewing gums can be used in combination for people who experience difficulty quitting smoking. However, these treatments should be supervised by a physician. Otherwise, unsupervised use of the methods can affect your health adversely.

Nutrition

Studies suggest a link between nutrition and cancer. Nutrients may have both negative and positive effects. Hazardous substances may develop in nutrients, which can contain both anticancerous and precancerous substances due to cooking and storage conditions.

Some nutrients can prevent cancerous effects of harmful chemical substances, if they are cooked properly. Toxic chemicals, which cause cellular damage that leads to cancer, are called oxidants or oxidizing agents. Some nutrients or leaves, flowers, fruits, corms, and seeds of certain plants contain beneficial chemicals which protect cells against oxidizing agents. These are called antioxidants.

Cancer can be prevented by paying attention to eating pattern and avoiding tobacco products. Because nutrition is one of the primary reasons behind various cancers such as stomach, colorectal, liver, pancreas, kidney and prostate cancers.

Eating Pattern to Prevent Cancer

It is, first, necessary to strengthen the immune system and avoid foods and habits that may cause cancer in order to prevent cancer. Items of four food groups should be introduced to meals to prevent cancer.

Making a room for bread group, meat group, diary group and fruit-vegetable group in daily diet or in other words, regular and correct eating pattern is crucial in prevention of cancer. Mediterranean diet should be preferred to consume fruits, vegetables and olive oil abundantly, but it is also necessary to avoid saturated fats.

Specialists emphasize the need for introduction of antioxidative nutrients (legume, all vegetables and fruits, whole-grain group, fish and olive oil) into the daily diet.

Eating Rules to Prevent Cancer

Annually, 13 million new cancer cases are diagnosed worldwide, while the figure is 150 thousand in Turkey. Studies on cancer cases with exponential annual increase demonstrate that wrong diets may lead to cancer. Then, how are we supposed to eat and what are key points to prevent cancer?

Here are itemized rules of a healthy diet

Say Farewell to Excessive Weight

Obesity is a disease which may lead to cancer. Therefore, lose your excessive weight. Follow an appropriate diet program and increase your physical activities. Seek professional support from your dietitian and physician if you cannot manage your body weight.

Eat Foods from All Nutrient Groups

Risk of cancer is higher in individuals who have a mono diet. Therefore, make a room for all food groups in your table. (Meat, egg and legume, milk and dairy products, vegetable and fruit group, fat and oil group)

Decrease Fat Consumption

Cook your foods with oils or use low amounts of fat. Consume foods rich in fat such as buttermilk, cream and mayonnaise, and fried foods in low amounts. Do not consume foods which contain trans fatty acids such as margarine, French fries, deep fried foods to prevent cancer.

Add Unburned Fats to Your Food

Prefer certain cooking methods, such as boiling, roasting and poaching, and add oil on the cooked meal. Do not forget that deep fried and barbecued foods have cancerous substances.

Eat Fish 3 Times a Week for Omega 3

Consume poached or roasted fish products twice or thrice a week to gain protective effects of Omega 3 fatty acids. Your diet should necessarily contain seeds that contain this fatty acid, such as soy and canola oil, soy bean, flaxseed, hazelnut and walnut, and portulaca.

Prefer Low-Fat Meat and Skimmed Yoghurt

Full-fat milk, yoghurt, cheese and meats contain high amount of saturated fat. Prefer low-fat alternatives of these products to prevent cancer. You should always remember that high fat consumption increases the risk of lung, rectum, breast and prostate cancers.

Do Not Be Deceived By Taste

Eat low-fat meat twice a week. Avoid the skin of chicken and turkey meat, as it is very rich in fat. Limit consumption of processed meat products which contain high amounts of fat and preservatives, such as bologna sausage, salami, sausage and pastrami, to avoid cancer.

Milk is Preventive for Cancer

You diet should necessarily contain milk and dairy that are rich in calcium, phosphorus, Group B vitamins and that are especially protective against colorectal cancers. Consume 2 to 3 glasses of semi-skimmed milk and yoghurt to prevent cancer.

Do You Drink Kefir?

Kefir, probiotic milk and yoghurt contain bacteria that are good for your health and strengthen your immune system. You may drink 1 glass of these anti-cancerous products every day.

Eat More Oats!

Eat 6 or more servings of nutrients from the grain group every day. Whole-wheat bread, grains and legume which have higher nutritional value should be preferred over processed white flour, white bread and rice.

Do not dispose boiling water of legume, pasta and vegetables to minimize loss of nutrients and vitamins in order to prevent cancer.

How Many Servings of Fruit You Eat?

Do you know that risk of cancer is two times higher in people with low fruit and vegetable intake? Fruit consumption is especially protective against lung, esophagus, mouth cavity, pancreas, stomach, colon, rectum, urinary bladder and larynx cancers. Eat 2 to 4 servings of raw vegetables, salads and vegetable meals and 3-4 servings of fruit to prevent cancer.

Reduce Sugar Intake

Do you know that risk of cancer is two times higher in people with low fruit and vegetable intake? Fruit consumption is especially protective against lung, esophagus, mouth cavity, pancreas, stomach, colon, rectum, urinary bladder and larynx cancers. Eat 2 to 4 servings of raw vegetables, salads and vegetable meals and 3-4 servings of fruit to prevent cancer.

Too Much Salt Intake Is A Risk Factor For Stomach Cancer

Consuming salt too much and eating salty foods increase risk of stomach cancer. Avoid eating too salty foods often, such as brine and pickle.

You can decrease salt intake by adding spices like thyme, mint, red pepper, onion, garlic and parsley to your foods while cooking. Prefer freezing the foods for storage instead of salting.

Do Not Eat Blue Cheeses!

Grains, flour, dry legumes and oily seeds, such as walnut, hazelnut and peanut, as well as spices may get moldy and toxins may develop, when they are stored in humid areas: Amongst these toxins, aflatoxin is especially a risk factor for liver cancer. Store these foods in dry and cool places. Avoid eating blue cheeses to prevent cancer.

Drink 2 Liters of Water A Day

Consume 1.5-2 liters of water and fluids every day as a preventive measure for cancer. The fluids you drink may be water, fruit juice, tea, herbal tea (linden, sage, green tea, rose hip etc.), compote and stewed fruits as well as ayran (buttermilk).

Avoid Alcoholic Beverages

Consume 1.5-2 liters of water and fluids every day as a preventive measure for cancer. The fluids you drink may be water, fruit juice, tea, herbal tea (linden, sage, green tea, rose hip etc.), compote and stewed fruits as well as ayran (buttermilk).

Sports

It is, now, known that regular exercise not only ensure weight control, but it also strengthens the immune system and most importantly, reduces the risk of cancer. It is important to do jogging for at least 30 to 40 minutes a day by wearing training shoes, such that your heart rate increases. Intense exercises at least 1-2 day(s) a week is good for health.

Nowadays, obesity is health problem for a major part of general population, including childhood; in other words, overweight is a risk factor especially for breast, ovarian, endometrial and colon cancers. Regular exercise normalizes body weight, but it is also preventive for development of cancer.

You Can Exercise Everywhere!

Even ‘light activities’, such as cleaning the house, yard work, playing with children and grandchildren and walking your dog, are good for health. Physical activity is a must for all age ranges. Childhood requires more intense and heavier physical activities than adulthood and advanced ages. Exercise and sports should be done two to three hours after meals.

A Pair of Shoes and a Safe Route Are Sufficient!

We should increase our mobility and physical activity for healthy aging. For this purpose, we need nothing except a pair of shoes and a safe route to walk. Unfortunately, our roads are not safe enough; but it is beneficial not to miss the chance if you find an appropriate route.

The main target is 10 thousand steps a day. Your targets should be realistic while doing sports; otherwise, the potential benefit can turn into damage and may even cause death. It is acknowledged that a health check-up is wise before one starts doing sports.

• Prefer public transportation while going to work.
• If you are driving to work, park your vehicle a little far from your workplace and walk.
• Use stairs several times a day in office.
• Use stairs instead of elevator.
• Spend your holidays outdoors rather than indoors and move.
• Do not bend forwards while sitting, stand and walk upright.

Some Practical Home Exercises

Push-up

This exercise can be done on door/wall and on your knees or toes on floor. Open your hands approximately to shoulder width and put them on floor or wall/door. In this position, bend your elbows and move your body towards floor/wall/door. Thus, you can train muscles of your arm and trunk.

Sit-up

Lie on floor while your knees and hips are slightly bended. While lying in this position, lift your body from the floor by 30-45 degrees and wait for 5 seconds. This exercise strengthens abdominal muscles.

Reverse Sit-up

Lie on floor facedown and place your hands on sides. While lying in this position, try to lift your head and body from floor and wait for 5 seconds. This exercise strengthens back muscles.

Sitting Down- Standing Up Using Couch / Chair

Sit down on couch/chair by crossing your arms in front of your chest wall. While sitting in this position, stand up from chair and sit again; repeat the move. You can decrease the height of chair/couch to make this exercise more challenging. This exercise strengthens leg and hip muscles.

Ascending and Descending Stairs

This is indeed a physical activity; but you can do this with a higher pace as an exercise.

4-Step Exercise at Workplace

• Go next to a door or corner of room. Elevate your arms up to shoulder level, turn your face towards corner/wall, bend your elbows and put them onto door/corner and lean your body forward. Stay in this position for 30 to 45 seconds and repeat it 4 to 5 times.
• Use one hand to bend your head sideways and put other hand towards your low-back from behind while your elbow is flexed. Stay in this position for 30 to 45 seconds and repeat it 4 to 5 times.
• Place your hands on your low-back. Try to approximate your elbows behind without taking off your hands from low-back. Stay in this position for 5 seconds and repeat it 20 to 30 times.
• Try to stand upright while your hands are at sides and move your shoulders upwards and backwards in this position. Stay in this position for 5 seconds and repeat it 20 to 30 times.

Common Reason of Diseases; Sedentary Lifestyle!

Physical immobility is the 4th most common risk factor that causes death worldwide, while it is also one of the main causes of obesity – a condition regarded as epidemic of modern era.

Today, it has been proven that drugs are not solely sufficient for treatment of many diseases such as diabetes mellitus, cardiovascular diseases, arthritis, osteoporosis, hypertension and hyperlipidemia (increased fat level in blood).

Regardless of drugs you use, you cannot take your diseases under control without exercise. Here is a list of diseases caused by physical immobility,

• Diabetes
• Obesity
• Hypertension
• Cardiovascular Diseases
• Diseases of musculoskeletal system
• Certain cancers
• Respiratory tract diseases