Explaining cancer prevention

Explaining cancer prevention

Is there any methods to prevent cancer formation

Cancer can be prevent to be formed by many methods which if done well can give good results these methods can be divided into three main types such as prevention of the cancer formation from the starts by primary cancer prevention or prevention cancer formation in people have high risk of cancer formation by secondary cancer prevention or prevention of cancer formation after cancer removal from primary site known by tertiary cancer prevention such as

   

 Cancer prevention can be divided into three stages

primary cancer prevention (i.e., pre­venting initial cancers in healthy individuals by means prevention cancer formation from the start in normal healthy people

 

  secondary cancer pre­vention (i.e., preventing cancer in individuals with premalignant conditions

by means prevention cancer formation in people have a premalignant diseases such as familial polpyposis or leukoplakia familial breast cancer

 tertiary cancer prevention (i.e., preventing second pri­mary cancers in patients cured of their initial disease by means prevention of recurrent cancer formation in people have previously cancer

Primary cancer prevention

There are certain agents which contributed in cancer formation which known by carcinogenic substances which if present in the body or body exposed to it can be lead to these cancer formation such substance either can found either in the diet or in the air or in the water or by exposure to it during working or by inhalation or drinking it

These carcinogenic agents  can be divided into

  

Tobacco smoking

 Which it is considered as high risk factors for formation of many cancers types such as cancer mouth lips tongue pharynx larynx esophagus lung kidney bladder cancers so the risk of development of these cancers can by avoided by prevention of all types of tobacco smoking which either taken by inhalation or chewing these known as inhalation carcinogens

Alcohol drinking 

Which considered high risk factors which associated with many cancers such as liver or hepatic oral esophagus pharynx larynx colon rectum and breast cancers these depend on the amount of drinking so these cancers can be decreased the incidence of formation by stopping alcohol abuse

Diet

There are relation ship by some types of diet eating and cancer formation such as increased consumption of preserved and red meat or smoked meat or pickled vegetables which may contains nitrose compounds such as nitrosamines which considered as carcinogenic agents for development of many cancers such as esophagus colon and rectum cancers so decreased using of these agents associated with decreased incidence of cancer formation

Increased fat content in diet especially after prolonged heating because it provides carcinogenic polycyclic hydrocarbons also high intake of fats reduce the benzpyrene hydroxlase activity in gastrointestinal tract mucosa this enzyme responsible for convert the potent carcinogen benzpyrene to inactive derivatives theses associated with increased risk of cancer colon and rectum 
  There are many foods types which may have protective effects against cancer formation such as diet rich in vegetables and fruits so it is better to taken it daily

Radiations

There is strong relation by exposure to radiation and formation of certain cancers types

These radiation may be
  
Ionized radiation

 such as X rays gamma rays alpha and beta particles which increased risk factors for formation of leukemia lung cancers oral pharynx larynx and other solid cancers 

 Non ionized irradiation or ultraviolet rays

Repeated and prolonged exposure can lead to skin cancers such as squamous cell carcinoma basal cell carcinoma and melanoma
Examples for these radiation are Hiroshima and Nagasaki atom bombs

Infections

There are some types of cancers are related to certain infections either by viral  bacterial or parasitic infections such as 

Viral infection
 

Hepatitis C and B virus associated with liver or hepatic carcinoma
Human papilloma virus associated with cancer cervix in female

 Bacteria

Helicobacter pylorus associated with stomach or gastric cancer

Parasitic

Liver flukes such as Opisthorchis viverrini associated with bile duct carcinoma or cholangiocarcinoma
Bilharziasis or schistosomiasis associated with cancer bladder common in Egypt country

Environmental pollution

Environmental pollution may include air which we are breathing water and soils may containing certain chemical agents or carcinogens such as exposure to arsenic associated with skin cancer ,food contamination with aflatoxins associated with liver cancer also exposure to coal tar associated with skin and scrotal cancers

 Certain occupation exposure

This related to the nature of the job where people work such as they may exposed to certain carcinogenic agents either by inhalation or by direct contact through skin these carcinogenic are associated with increased risk of cancer lung larynx pharynx and skin cancers  such as asbestos and silica are associated with cancer pleura or chest cavity mesothelioma

Physical activity

Regular exercise and good body build with good healthy diet associated with decreased incidence of cancer formation because obesity associated with increase risk of cancer formation such as breast endomtrium esophagus colon cancers

Good observation and cancer screening with avoidance of these agents can be reduced the risk of cancer formation or prevent its aggressive effects 

Secondary cancer prevention

This type of cancer prevention can be prevent cancer formation in patients have premalignant conditions such leukoplakia which it is precancerous conditions characterized by formation of white patches on the tongue or mouth cavity as inside the cheek due to chronic irritation such as from smoking which can results in cancer tongue or lips or cheek or oral mouth cancers these can be prevented either by prevention of smoking or surgical removal of these patches before it transformed to cancer also can be present in gastrointestinal or bladder mucosa

Other examples for secondary cancer prevention are breast cancer which it is familial cancer so mother with breast cancer his siblings are more liable for breast cancer formation so they can do surgical bilateral or both sides breast removal (mastectomy) as a prophylactic from cancer formation especially in those have genetic inheritant

Also familial adenomatous polyposis has 100% risk of cancer transformation to cancer colon so these patient can do prophylactictotal removal of the colon and rectum ( proctocolectomy) to avoid cancer formation or do( mucosectomy )operation in ulcerative colitis

It is important for surgeons to be aware of these preventive options since they are likely to be involved in the diagnosis of premalignant and malignant conditions and will be the ones to counsel patients about their preventive options

Tertiary cancer prevention

This types of cancer prevention means prevent cancer formation after its removal so prevent it is recurrence this can be done by good removal of the primary cancer from the start with good treatment and observation follow up repeated examination
The patient given radiotherapy or chemotherapy or hormonal therapy as adjuvant treatment after cancer removal to prevent cancer recurrent such as in breast cancer the patient are taken tamoxifen hormones which reduce the incidence of cancer recurrence this called chemoprevention
   
   Several other agents. including raloxifene and fenretinide, also show promise for breast cancer prevention

 Celecoxib has been shown to reduce polyp number formation and polyp burden in patients with familial adenomatous polyposis (FAP) leading to its approval by the FDA for these pa­tients

 In head and neck cancer, 13-cis-retinoic acid was shown to both reverse oral leukoplakia and reduce second primary tu­mor development
   
 There are  high-risk cancers include hereditary cancer syndromes such as hereditary breast ovarian cancer syndrome ,hereditary diffuse gastric cancer. multiple endocrine neo­plasia type 2
FAP, and HNPCC, as well as some nonhereditary cancers such as chronic ulcerative colitis

 Most prophylactic surgeries are large ablative surgeries (e.g., bilateral risk-reducing mastectomy or total proctocolectomy

 Therefore it is important that the patient be completely informed about potential surgical complications as well as long-term lifestyle consequences

 Further the conservative options of close surveillance and chemoprevention need to be­
discussed

 The patient's cancer risk needs to be assessed accurately and implications for survival discussed. ultimately

The decision to proceed with surgical prevention should be individualized and made with caution


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