30 Things Oncologists Do to Prevent Cancer
You're about to hear advice from the last people you'd ever want to meet. Oncologists specialize in the diagnosis and treatment of cancer. If you're talking to one, and you're not at a dinner party, you might be one of the 100 million folks around the world who have it.
With those staggering stats, you might think getting cancer is an inevitably. It isn't.
Read on to discover 30 things the experts do—not to treat cancer, but to prevent getting it in the first place. They would know.
Get That Looked At
"I am very careful about keeping up with proven cancer screening interventions," says Amy Tiersten, MD, clinical breast medical oncologist at Mount Sinai. She stays current on preventative tests like colonoscopy, skin cancer exams, and gynecologic follow-ups.
Late diagnoses are a leading cause of premature death due to cancer. Interventions, like those Dr. Tiersten recommends, allow for early detection and diagnosis where patients can start treatment earlier. This is especially impactful in breast, cervical, and colorectal cancers.
The American Cancer Society recommends:
- Colonoscopies begin at age 45.
- Pap smears to test for HPV/cervical cancer should start at age 21 and be scheduled every 3 years, not annually.
- Mammograms are optional at age 40, but should be done annually at age 45-54. After age 55 schedule mammograms every two years.
Get the HPV Vaccine
Ten years after the HPV vaccine was introduced, there is "compelling evidence" that we're on track "to eradicate cervical cancer within decades." A June 2019 study reviewed 60 million individuals', mostly girls and women, eight-year post-vaccination status and found that the vaccine has exceeded expectations.
The CDC recommends both boys and girls get the HPV vaccine at ages 11-12, with the second dose within a year. It's recommended up to age 26 for women and age 21 for men.
Newer versions of the vaccine require two doses instead of three, ensuring adherence to the full vaccination schedule. As well, it's gender-neutral and targets more HPV strains.
Snack on Exercise
Exercise every single day… that's the walk Kathryn Schmitz, Ph.D., a leading exercise oncology researcher at Penn State University, walks and talks. "We oncologists run, walk, or roll our way to cancer prevention," she said, citing research that supports a relationship between physical activity and cancer prevention. She's the biggest proponent of strength training, something she introduced in the chemo lab at Penn State Cancer Institute and shares as "exercise snacks" each week on her Instagram. "I try to exercise 30 minutes a day to stay fit. We know that regular physical exercise does reduce cancer risk in many cases. Decreasing your body weight, even by 5%, can make a big difference in terms of cancer risk," says Xavier Llor, MD, Medical Director of the Cancer Screening and Prevention Program.
Believe that No Man is an Island
"Embrace your social networks; recognize who loves you and let them in," is how Dr. Don Dizon, MD, FACP, FASCO, director of medical oncology at Rhode Island Hospital and Professor of Medicine at Brown University prevents cancer. He says it's well-established that whether your social network includes a spouse, kids, best friend, or church, these connections are key to good health and that social isolation is associated with an increased risk of death.
"In one study, social isolation scores were associated with risk of death from heart disease and in all-cause mortality. This was true for men and women, Blacks and whites."
Steer Clear of Red Meat
As an oncology clinical pharmacist, there are several things Allison Baxley, PharmD, BCOP of Stephenson Cancer Center does to prevent cancer. She recognizes that many elements are out of our control, like genetics, so she does all she can to reduce the risk through things she can control.
"Working primarily in GI oncology, I'm very aware of the link between colon cancer and processed and red meat consumption. I eat these in moderation, and rarely if ever eat highly processed meat like hot dogs and bacon."
She avoids what Micahel Pollen has called "edible food-like substance," which is the majority of what's in the center aisles of the grocery store.
Eat More Plants
Our daily diet choices play a powerful role in cancer prevention, reminds Dr. Terry Wahls, author of The Wahls Protocol series. For optimal cancer prevention, she aims for 9 cups of plant-based foods each day: 3 cups of greens, 3 cups of sulfur-rich foods like cabbage, onions, or mushrooms, and 3 cups of color from berries.
"We can choose to eat more greens and non-starchy vegetables and berries to markedly reduce the risk of developing cancer (and surviving cancer if it is diagnosed)," she explains. "Or we can choose the standard American diet, full of sugar and flour, which drives up insulin and insulin-like growth hormone and have a much higher risk of pre-cancers and overt cancers."
Perform Breast Self Exams
LaShyra "Lash" Nolen, an MD candidate at Harvard Medical School, points out that Black women have a disproportionately higher rate of mortality from breast cancer than white women, according to 2016 research.
"Therefore, I think it is so important for me, as a young Black woman, to take agency over my body," shared Nolen. "One way I do this is by regularly performing a physical exam of my breasts to search for abnormalities or unusual lumps."
She adds that, sometimes, women allow others to know their bodies better than they do themselves, but that this has to change in order to detect cancers at earlier stages and improve outcomes.
Drink Less Alcohol
As an American Cancer Society Research Professor and Associate Dean for Oncologic Sciences at Brown University, Dr. Wafik El-Deiry says it's important to remember that half of all cancer is preventable. One of his preventive efforts is to limit or moderate alcohol consumption, as alcohol has been linked to cancers of the mouth, throat, liver, colon, breast, and others.
"Be aware and keep in the back of your mind that this is a substance that can do harm," he advises. El-Deiry says there's a lot of evolving and emerging data on the association between alcohol and cancer, but that the relationship does exist.
How much is too much? The American Cancer Society advises no more than 2 drinks per day for men and 1 drink per day for women.
Watch Your Weight
Jeffrey Meyerhardt, MD, MPH, medical oncologist for the Dana-Farber Cancer Institute, works hard to maintain a healthy body weight. He cites consistent evidence in observational studies that link obesity and higher BMI with a variety of cancers, including colorectal, ovarian, and pancreatic.
In particular, he cited a 2003 study that analyzed the relationship between body weight and mortality from cancer in nearly one million American adults. When the heaviest participants had a BMI of 40, death rates from all cancers were 62% higher in women and 52% higher in men when compared to those of "normal weight."
All Things in Moderation
"I eat a balanced diet of real food. The less processed, the better!" says Allison Betof Warner, MD, Ph.D. of Memorial Sloan Kettering Cancer Center. Of course, this melanoma medical oncologist splurges and doesn't always eat healthy (like the rest of us!), but when she does, moderation is key.
While no single food can prevent cancer, a well-rounded diet with a variety of vegetables, fruits, and grains can go a long way toward risk reduction.
"I try to live by the 80/20 rule," she caveats. That's 80% whole, healthy foods in balanced proportions and 20% treats and other "less" healthy stuff.
Soak up the Sun
"I make sure to get plenty of Vitamin D," says Kevin Dawravoo, MD, hematologist and medical oncologist at Northwestern Medicine Cancer Center Warrenville. He cites numerous studies that support the anti-cancer effects of this nutrient. Anyone can check for a vitamin D deficiency with a simple blood test at their doctor's office. That deficiency was linked in a 2014 study to a greater risk for more aggressive prostate cancer.
The best source for vitamin D is the sun, but new research says sunblock does not compromise the absorption of the vitamin. Fish is the best food source for vitamin D, including salmon, rainbow trout, and swordfish, as well as fish oil/cod liver.
Catch Some Zzzs
Most Americans are "woefully sleep deprived," says Dr. Stephen C Schimpff, MD, MACP. Board certified in medical oncology, Schimpff is sure to "get enough sleep" each night. It's a subject important enough that he addresses it in his book, Longevity Decoded – The 7 Keys to Healthy Aging.
"Inadequate sleep predisposes to high blood pressure, stress, overeating [in general] and the wrong foods, obesity, and hence predisposes to cancer," he continued
Monisha Bhanote, MD, FASCP, FCAP meditates regularly, a practice she says can "help balance life's daily stressors." The most benefit is gained from daily practice, even if just five minutes, than if done sporadically.
The triple board certified physician at Baptist MD Anderson Cancer Center says, "Managing stress is important for preventing chronic disease and predisposing one to cancer. Stress weakens the immune system and lowers its defenses to fight diseases." Consistent meditation can move the body into a parasympathetic state (rest and energy conservation) as opposed to a continuous sympathetic state (aka fight or flight).
Bhanote cited a 2004 study that found chronic stress can impair the body's immune response and contribute to the development of cancer.
Implement a No Phone Zone
A variety of sources like cell phones, wifi, power lines, and battery-powered cars bombard us every day with EMFs, or electromagnetic fields. Dr. Jonathan Stegall, an integrative oncologist and medical director of The Center for Advanced Medicine in Atlanta, says he tries to limit his exposure to EMFs.
"I recommend that my patients not hold a cell phone up to the ear, and instead hold it away from the body using speaker phone. This significantly minimizes the amount of radiation absorbed by the body," advises the author of the bestselling book Cancer Secrets. He also recommends installing a timer on any WiFi modem/router at home so that it turns off while you are sleeping.
Put Family First
It's family first for Dr. Timothy S. Pardee, chief medical officer, Rafael Pharmaceuticals and oncologist and director of Leukemia Translational Research at Wake Forest Baptist Health. He believes this time is super important, and notes that familial relationships can reduce stress and increase overall well being.
A global study found that larger families, those with many children, have a reduced risk of cancer. And that's not just the nuclear family. Larger household sizes with multiple generations living together enjoy that same protective benefit. The study authors cite the "special emotional environment" as having a positive effect that contributes to disease resistance, as well as the benefit of family members supporting each other in a healthy lifestyle.
Go on Trial
Did you know you can get paid to prevent cancer? Roshni Rao, MD, Chief of the Division of Breast Surgery at New-York Presbyterian Hospital and Columbia University Medical Center and says even she participates in clinical trials. "I was part of an MRI trial where I was in [the] machine for over an hour, and I got paid $25!," she said.
She's also participating in the T-MIST trial, a national study working to identify how often women should get mammograms and what type of mammogram to get. Rao says this trial is currently open at Columbia and seeking up to 165,000 women to participate.
"I drink a few cups of green tea or coffee every day," says William W. Li, MD, author of Eat to Beat Disease: The New Science of How Your Body Can Heal Itself. After 20 years of cancer prevention research, he says he's well aware of the scientific evidence that points to tea and coffee doing the body good.
They each "contain different types of polyphenols (micronutrients from plant-based food), but they all activate our body's key health defense systems (starving cancer, feeding our healthy gut bacteria, repairing damaged DNA, improving immunity) that help us resist cancer. From lab studies to clinical trials to large-scale public health studies showing that tea or coffee lowers risk across different forms of cancers, I consider it a no-brainer to drink these beverages." And it's a cherry on top that he loves the taste!
Sign Off and Log Out
The lead authors of a large-scale study from the University of Glasgow in 2018 now know it's best to keep screentime to a minimum. They analyzed nearly 400,000 people and found a strong correlation between higher screentime and a higher risk of all-cause mortality, cardiovascular disease, and cancer. This was independent of known cancer-causing factors like smoking, BMI, and diet.
The more discretionary, or leisure, time spent on tablets, smartphones, and other media devices directly contributes to a sedentary lifestyle, the result of which is lower physical fitness, grip strength, and overall poor health.
Nearly half the deaths from an astounding 12 different cancers can be attributed to smoking cigarettes: liver, colorectal, lung, oral and throat, esophageal, larynx, stomach, pancreas, bladder, kidney, cervix, and acute myeloid leukemia. That's why it's a smoke-free life for Dr. Wafik El-Deiry, Associate Dean for Oncologic Sciences at Brown University. While fewer people smoke in 2019, plenty are still addicted to one of the single-most unhealthy habits.
He does note that quitting smoking can have a positive impact, but that the risk never fully goes away compared to the general population. It can take 8-10 years to truly minimize the risks associated with cigarette smoking.
Just Say No to Vaping
Likewise, Dr. El-Deiry isn't vaping, either.
"The message needs to get out that [vaping] is potentially cancer causing and we have to be aware," he warns. "The more we talk about it…to save anyone…is worth it."
He says the more we learn about vaping the more we realize how unsafe it is in different ways. The vapor exposes users to chemicals known to cause cancer, for instance. And while e-cigs have their place for smokers trying to quit, the vape pens aren't benign. El-Deiry reminds that no substantial research has yet been completed on the relationship between vaping and cancer.
The National Institutes of Health warns that teens are vaping in record numbers; higher than opioid or marijuana use.
Walk a Mile in Your Shoes
Dr. Katherine Crew, director of the Clinical Breast Cancer Prevention Program at New York-Presbyterian and Columbia University Medical Center, walks at least a mile every day. "For a busy oncologist, it's not always easy to find time to lead a healthy, active lifestyle, but I try to incorporate it into my daily routine."
Each of those steps is worth the time. Walking a single mile each day at a moderate 20-minute pace can reduce mortality in breast cancer patients by as much as 40% and almost 30% in prostate cancer patients. Risk for endometrial cancer is also reduced by a moderate intensity walking regimen.
Dr. Crew also takes the stairs "whenever it's humanly possible" to gain an extra burst of physical activity in her day.
Save Your Skin
As an exercise oncologist, Kathryn Schmitz, PhD gets as much movement as she recommends. Before heading outdoors though, "I slap on the sunscreen, since exercise increases the risk of melanoma by 28%." While this 2016 study found that exercise reduces the risk for 10 different cancers, it increased risk for malignant melanoma significantly.
Schmitz echoed the researchers' assumption that increased time exercising or enjoying leisure physical activity increased exposure to the sun, which in turn increased the incidence of skin cancer. If you're spending time outside, be sure to wear a broad spectrum sunblock with SPF 30 or higher and remember that "water resistant" is not the same as "waterproof."
Reduce, Reuse, Recycle
Making "greener" choices can ultimately support everyone's goal to reduce their risk of cancer. Climate change is having a negative impact on more than just the earth's health and sustainability. Human life is taking a negative toll, too.
Stratospheric ozone depletion is implicated in an increase in skin cancer incidence, like melanoma, and scientists expect to see a continuation over the next couple of decades.
Exposure to air pollution increases the risk of breast cancer in premenopausal women. And the very air we breathe has been deemed carcinogenic by WHO, citing a direct correlation to nearly a quarter-million lung cancer deaths in 2010 alone.
Fight with Fat
How much "good" fat do you have in your diet? It's something Dr. Stephen C Schimpff, MD, MACP, author of Longevity Decoded – The 7 Keys to Healthy Aging, prioritizes in his own diet. He recommends avocado, nuts and seeds, olive oil, and fish like tuna and salmon.
What makes a fat good for you? These unsaturated fats remaining liquid, not solid, at room temperature and are generally derived from plants.
Tree nuts like almonds, walnuts, and pecans can decrease your risk of colon cancer, which is why Kevin Dawravoo, MD, hematologist and medical oncologist at Northwestern Medicine Cancer Center Warrenville, makes them a regular part of his diet.
For men and women, a 2018 study found a "statistically significant" link between eating nuts three times per week and a reduction in colorectal cancer risk.
Another 2018 study found that stage 3 colon cancer patients who had two 1-ounce servings of tree nuts (which included walnuts, cashews, almonds, pistachios, hazelnuts, pecans macadamia nuts, and Brazil nuts) each week were 42% more likely to experience disease-free survival and 57% greater chance of overall survival.
Turn up the flavor experience of roasted vegetables, rice, soup, smoothies, and tea by adding turmeric. This Indian spice, most common in curries, has an earthy sweet-pungent flavor and bright orange hue that can truly transform any food. That, and the cancer-preventative benefits, are why Roshni Rao, MD, Chief of the Division of Breast Surgery at New-York Presbyterian Hospital and Columbia University Medical Center, loves to eat turmeric-laden foods.
"Most of the studies do show a benefit from this anti-inflammatory, and there is no study that shows that it is detrimental," she says.
A 2015 study reviewed the multifaceted role of curcumin (the source of turmeric) in cancer prevention, and found that it can "suppress initiation, progression, and metastasis of a variety of tumors."
Pack Up the Plastic
The plastics we brush our teeth with, eat and drink from, build toys with, type on, and so much more inundate every aspect of our lives, but the chemicals within are taking away our health and mortality. Especially when plastics are heated or scratched, they can leach the chemicals used to develop the products. Once inside our bodies, these chemicals, like BPA, disrupt the natural role of hormones and create an imbalance that can ultimately lead to cancer.
"BPA has been shown to play a role in the [development of]…hormone-dependent tumors such as breast and prostate cancer," states a 2015 study that reviewed the health risks associated with exposure to bisphenol A.
Avoid plastics whenever possible by looking for BPA-free products and carrying reusable glass or steel drinking vessels. Do not cook or reheat food nor store hot food in plastic containers.
Give Up the Grill Marks
"Especially important in the summertime is decreasing charred food consumption," says Kevin Dawravoo, MD of Northwestern Medicine Cancer Center Warrenville. Reminding that the blackened char marks on grilled meat is a known carcinogen. It's something he rarely eats.
The concern is that when meat is cooked over open flame, and burned or blackened, chemicals known as HCAs and PAHs develop. When consumed these can alter a person's DNA which increases the risk of cancer.
In rodent studies, HCAs developed tumors breast, colon, liver, skin, lung, prostate, and other tumors. Similar rodent studies found that PAHs caused leukemia, and identified gastrointestinal and lung tumors. In epidemiologic studies, higher consumption of well-done and "barbecued" meat was linked to increased risk of colorectal, pancreatic, and prostate cancers.
Know Where You Come From
You might be bored answering all of your doctor's questions about your parents' and grandparents' health, but it truly matters. Dr. Wafik El-Deiry, Associate Dean for Oncologic Sciences at Brown University, knows his family history and strongly recommends that you do the same.
"Illnesses that are found in the family can be a major clue to what risks there are," he says, adding that a history of cancer is usually well known and not difficult to learn about.
Sharing your family history with your doctor means they can do additional screening sooner, and work to catch symptoms and tumors earlier, which is key in treating and curing cancer.
"This knowledge may also direct patients to genetic testing that can further help to figure out different options to manage the risks," he added.
Know If You're Dense
"Read your mammography results letter. In many states, including Connecticut, we, as radiologists are required to inform the patient whether or not her breast tissue is dense. If your breast tissue is dense, talk to your doctor about whether you need additional tests: a screening ultrasound or possibly even a screening MRI, the latter being a useful complementary screening tool in some women at higher than average risk of developing breast cancer. Please note that screening ultrasounds and screening MRIs do not replace mammography; rather, they are a complement to it," says Liva Andrejeva-Wright, MD, a Yale Medicine radiologist who specializes in breast imaging.
"It is important to know that screening mammograms do not prevent breast cancer. They do help by detecting cancer early in many cases, before it becomes palpable, however, and therefore prevent disease and treatment related morbidity that would have occurred if the cancer was detected later by the patient or her doctor," she added. And to live your happiest and healthiest life, don't miss these 60 Secrets Nurses Don't Want You to Know.