Cancer encompasses a number of diseases in which abnormal cells divide uncontrollably and can cause damage and/or destruction in body tissues. But there are a number of factors that can affect that risk and, therefore, can be prevented.
And while there are environmental and hereditary risk factors, “the vast majority of tumors are due to environmental risk factors, which are usually related to obesity,” says Suraj Samtani, director of the Chilean Society of Medical Oncology (SCOM).
This factor “causes a tumor to grow. An obese person releases certain inflammatory cytokines (small proteins that regulate cell function) into adipose tissue producing a microenvironment for the tumor to grow,” Samtani explained.
On the other hand, sedentary lifestyle can be another risk factor: “It was shown that exercise can prevent breast cancer from appearing by 30 or 40%, aerobic exercise 30 minutes a day,” explained the doctor at the Las Condes Clinic.
Food, meanwhile, promotes inflammation or not of the body, an equally important factor in this regard. According to the medical oncologist, the consumption of processed foods, sausages, red meat “generate a pro-inflammatory state and a microenvironment so that the tumor can grow,” that is, its consumption is not related to a type of tumor “but they are factors that influence the formation of cancer,” he explained.
Other factors include smoking, alcohol consumption, environmental pollution and unprotected sex in the case of cervical cancer. In addition, aging contributes to the development of tumors, since according to Dr. Samtani, the older the DNA repair system, responsible for eliminating tumors, is affected by these different risk factors, which is why tumors can develop.
Although there are also “hereditary syndromes” that lead to an increased risk of tumor development, the frequency “is 10% or 15%,” said the oncologist.
Incidence: Is there a generalized increase in cancers?
For Gonzalo Giornelli, head of the Department of Gynecology Oncology at the Alexander Fleming Institute (Buenos Aires, Argentina), the situation is different according to the disease. In the case of cervical cancer, for example, the specialist noticed a “decrease in incidence”, but not in other tumors.
“In the other tumors, the increase in incidence has to do with people being more aware and more cases of cancer are being identified,” said the master’s degree in Molecular Oncology and illustrated, for example, the campaigns for the use of sunscreen in summer. Education is key in terms of prevention.
“In the prevention of cervical cancer, it is very important to communicate about vaccination, to get rid of all those myths that the vaccine is not effective, that it is dangerous, because the earlier you get vaccinated the better, although it can be done until age 45,” he said.
The case of Australia is exemplary in this regard. “Vaccination is so widespread there that genital warts no longer exist, for example, also caused by the human papillomavirus (HPV),” he said.
Education and detection, the keys
Cancer is the leading cause of death nationwide and therefore advancing in early detections is essential to make timely treatments. In this sense, Suraj Samtani stressed that to advance in earlier detections “the first thing is to educate the population.”
“The check is fundamental, because it is important to be able to detect this. There are no preventive exams as in breast cancer, but there are clinical and laboratory tests that guide us a little and make us intervene and generate a complementary study more focused on this, such as radiological exams, “he recommended.
Then, in case of the discovery of tumors, he explained that the next step is to diagnose through a biopsy to confirm if it is malignant or not, its histology and radiological studies to know the extent of the disease, if it is localized or if it has involvement in other organs of instance.
“Having that they have to go through a multidisciplinary committee that discusses all the variables of the treatment and then offers the best treatment for the patient,” he added.
Delays in diagnosis and treatment due to the pandemic
The spread of SARS-COV-12 produced a global before and after in all aspects of everyday life, even more so health and the systems that organize it. It also had an impact on the approach to cancer and for Dr. Giornelli, by his own decision or external reasons, the pandemic caused them to stop having controls, such as Pap smears.
The goal then of eradicating uterine cancer by 2030 not only remained a distant ideal, but its incidence and mortality are expected to increase by 200,000 new cases.
The projection generated global alert, as the situation is similar in different parts of the world.
“During the pandemic, the oncology units tried to keep functioning, but there was a delay in both treatment and diagnosis,” added Samtani, who also mentioned an estimated study that established that “there were more than three thousand more deaths from cancer in 2021, due to the delay due to the Covid-19 pandemic.”
On this issue, he stressed that special attention must be paid in the coming years due to the delay in diagnoses made during the most critical period of the pandemic, which “will cause another independent prognosis” that progress has been made in treatments.
Studies, treatments and the climate crisis in cancers
Ovarian cancer represents a peculiarity due to the increase in incidences.
“We have learned much more about this tumor in recent years about treatments and their novelties, but chemotherapy remains our best tool along with surgery to control it,” said the director of SCOM.
“In ovarian cancer, immunotherapy still does not play the essential role it plays in other types of tumors, if some specific treatments do, but in this case the detection is more complicated because the diagnosis is given by symptomatology,” he added.
By way of review, Dr. Giordelli recalled that “before” studies on the family of carcinogenic diseases focused on drugs that decreased tumor progression, but today “we are in immunotherapy and its combinations.”
“What is coming is the study of antibodies conjugated to drugs, immunotherapy that acts at different levels with agents that are being assigned, the problem is that there is still no antigen for the antibody that is 100% specific for uterine cancer, for example, but something is coming underway, ” said with satisfaction.
Finally, Dr. Samtani referred to the climate crisis “as a categorical risk factor”, since sun exposure puts at risk of melanoma, skin cancer of the most dangerous.
“To avoid this, it is very important to sunscreen, do not sunbathe at times of greatest exposure, hydration, exercise, avoid sedentary lifestyle, try to maintain a balanced diet, lower alcohol consumption because any permanent imbalance in our body leads to the suppression of the immune system, there are many associated factors that come together and that is why prevention and in other cases, Early diagnosis is paramount,” he concluded.
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