Prevention: The best anticancer drug

No one doubts that the cancer it is a multifactorial disease, a disease that develops as a composite of many forces, genetic and environmental. And if we have little ability to influence genetic parameters, we have a much greater influence on environmental ones, especially when they are related to our lifestyle. But how big is the environmental component in the development of cancer? Is it worth the effort to change our habits?

«Αξίζει και με το παραπάνω» δηλώνουν οι scientists που ποσοτικοποιούν τη συμβολή του τρόπου ζωής στην εμφάνιση και στην υποτροπή του καρκίνου. Διόλου τυχαία μια από τις συνεδρίες στο 29ο Ελληνικό Συνέδριο Κλινικής Ογκολογίας (ΕΣΚΟ), το οποίο έλαβε χώρα στην Αθήνα στο διάστημα 5-8 Απριλίου, ήταν αφιερωμένη στην πρόληψη μέσω παρεμβάσεων στον τρόπο ζωής. Κατά τη διάρκεια της εν λόγω συνεδρίας αφενός παρουσιάστηκαν τα δεδομένα που καταδεικνύουν τα οφέλη παρεμβάσεων όπως η excercise ή η σωστή διατροφή στην prevention and the recurrence of many types of cancer, on the one hand recommendations were given on how we could all, patients and non-patients, benefit from the findings.

Broad studies

There are cancers where the environmental component is almost self-evident. A typical case is lung cancer, 90% of which is attributed to smoking. However, the same is not the case with other types of cancer where the environmental component has a smaller but significant effect. To search for these other environmental factors that contribute to the onset and recurrence of cancer, scientists conduct meta-analyses of tens of thousands of published papers.

Από τέτοιου είδους μετα-αναλύσεις, οι οποίες συγκεντρωτικά παρέχουν στοιχεία για εκατοντάδες χιλιάδες ασθενείς, έχουν προκύψει τρεις παράγοντες με ιδιαίτερα σημαντική επίδραση στην εμφάνιση της νόσου: η κακή διατροφή, η obesity και η έλλειψη άσκησης. Αντιθέτως, διαπιστώθηκε ότι η σωστή διατροφή, η διατήρηση του σωματικού βάρους στα κανονικά επίπεδα και η τακτική άσκηση συμβάλλουν σημαντικά τόσο στην πρόληψη της εμφάνισης όσο και της υποτροπής της νόσου. Με άλλα λόγια, τα παραπάνω ευρήματα καταδεικνύουν ότι ο τρόπος ζωής μπορεί να λειτουργήσει ως φάρμακο!

Excercise

The health benefits of physical exercise have been known since ancient times. Especially for cancer patients, however, these have a huge range, which extends from a shorter stay in the hospital after surgery, to a better response to treatments and an increase in survival.

According to the data presented by Dr K. Kamposioras by The Christie NHS Foundation Trust in the UK, physical exercise was found to reduce breast cancer recurrence by 35% (applies to any type of breast cancer and at any time after diagnosis). Similarly, exercise has been found to increase the survival of patients who have undergone surgery for other types of cancer, such as rectal cancer.

But where are these benefits due to? Studies have shown that exercise induces the release of hormones (such as epinephrine) and/or metabolites (such as lactic acid produced by exercising muscles). These substances through the bloodstream reach the tumors and affect what scientists call the tumor microenvironment. That is, they affect, among other things, the cells of the immune system that fight the growth of tumors by enhancing their activity. Altogether, they make the environment unfriendly or less friendly for the growth of cancer cells, thereby promoting their apoptosis (cell death) and reducing their metastatic potential.

But how much exercise is needed for patients to reap its benefits? As noted by the professor of the University of Ioannina, Mr. Kostas Tsilidis, studies "recommend" 20 minutes of vigorous exercise or 40 minutes of brisk walking per day. Of course, each patient should talk to their doctor before starting exercise, but there is evidence that even less than recommended exercise is a better survival strategy than no exercise at all.

Body weight and nutrition

Obesity is a major risk factor for many diseases, including cancer. In order to calculate whether a person is obese, experts use the BMI (body mass index). It is the ratio of body weight to the square of height and based on the values ​​obtained a person is considered underweight if the BMI index is below 19, normal weight for values ​​from 19 to 25, overweight for values ​​from 25 to 30 and obese for values ​​above 30.

The πόσο σημαντικό είναι να διατηρεί κανείς το βάρος του στα κανονικά επίπεδα με βάση τον παραπάνω δείκτη αποδεικνύεται από πληθώρα μελετών που δείχνουν ότι ασθενείς με καρκίνο έχουν καλύτερη πρόγνωση, ανταποκρίνονται καλύτερα στις θεραπείες και εμφανίζουν μεγαλύτερα ποσοστά επιβίωσης σε σχέση με λιποβαρείς και υπέρβαρους ή παχύσαρκους ασθενείς. Τέτοιου είδους ευρήματα έχουν παρατηρηθεί σε πολλούς τύπους καρκίνου, όπως μαστού, προστάτη, παχέος εντέρου, μελάνωμα.

Of course, normal body weight goes hand in hand with exercise and appropriate nutrition. According to data from studies presented by the oncologist Mr. Stefano Lambropoulos, the role of nutrition is decisive in the response of patients to immunotherapies, which was found to be true in general and not only for cancers of the digestive system. For example, a high-fiber diet, such as the Mediterranean Diet, has been found to multiply the benefits of immunotherapy in melanoma patients.

The role of plant fiber is related to the maintenance of a normal intestinal flora (or otherwise intestinal microbiome, i.e. the set of symbiotic microorganisms that live in the human digestive system), which is also demonstrated by findings according to which strong doses of antibiotics given to patients even a year before immunotherapy reduce its effectiveness as they alter the composition of the microbiome.

From the above it becomes clear that the adoption of habits such as daily exercise and diet according to Mediterranean standards may be perhaps the cheapest "medicine" against cancer. A preventive and therapeutic drug, which should be part of the State's strategy against cancer. As characteristically noted by the oncologist lady Stavroula Drufakou, "for every euro invested in cancer prevention, the profit from treatments that will not be needed is estimated at 10 euros". Not coincidentally, the trend for exercise and nutrition programs to be part of the "treatment" recommended to patients after a cancer diagnosis is steadily gaining ground in many countries. An example we must follow.

Source: tovima.gr