Active against cancer – Successful ways to reduce your personal cancer risk
About every second German develops cancer in the course of his or her life. That is around 510,000 new cases of cancer per year. Experts expect an increase to 600,000 by 2030. According to the Robert Koch Institute, about 1.7 million people in Germany live with a cancer that was diagnosed in the last 5 years. On World Cancer Day (February 4th), experts from the Technical University of Munich (TUM), the Comprehensive Cancer Center Munich, the Bavarian Cancer Society and the Felix Burda Foundation provide information on successful ways to reduce the risk of cancer.
„Mortality can be significantly reduced through cancer prevention and early detection. The prerequisite for this is the acceptance of screening programmes by the population. However, only about 67 percent of women (20 years and older) and about 40 percent of men (35 years and older) participate. That is why we advise: Take cancer screening seriously and promote your health through a healthy lifestyle,“ emphasises Prof. Dr. med. Hana Algül, Director of the Comprehensive Cancer Center Munich (CCC Munich) and professor for tumor metabolism at the Technical University of Munich.
„Researchers see great potential in cancer prevention throughout Europe. If the interaction of prevention and early detection were optimized, 50-70 percent of cancer deaths in Europe could be avoided. Through nationwide prevention programs combined with translational cancer research and improved oncological care, a 10-year cancer-specific survival of about 75 percent would be possible in Europe in 2030,“ explains Prof. Volker Heinemann, MD, Director of the CCC Munich at the Ludwig-Maximilians-Universität München (LMU).
(Recommendations for tumor prevention: https://febs.onlinelibrary.wiley.com/doi/10.1002/1878-0261.12763).
„A healthy lifestyle could prevent 40 percent of all cancers. Physical inactivity, obesity, an unhealthy diet, stimulants and protection from UV radiation are risk factors for cancer that can be influenced.* These must be reduced in primary prevention so that cancer does not develop in the first place. Secondary and tertiary prevention aims to prevent the progression of the disease and to mitigate side effects and late effects caused by the disease or therapy. This applies in cancer aftercare, but also for children and adolescents with cancer for whom lifestyle is not the cause of the cancer,“ reports Prof. Dr. med. Renate Oberhoffer-Fritz, Dean of the Department of Sport and Health Sciences and head of the Chair of Preventive Paediatrics at the TU Munich.
(* See European Code Against Cancer: https://cancer-code-europe.iarc.fr/index.php/en/)
Sport reduces the risk of cancer.
„The effect of sport for cancer prevention can be explained using the example of colorectal cancer: We now know that muscles send out certain messenger substances via the blood to different organ systems. If the muscles are stressed, certain muscle hormones are released in the intestines, for example. If they reach the intestinal mucosa, they inhibit the development of intestinal polyps,“ says Prof. Dr. med. Martin Halle, Medical Director of the Chair and Polyclinic of Preventive and Rehabilitative Sports Medicine, at the Technical University of Munich.
Sport also indirectly influences mechanisms of sugar metabolism and insulin levels, and it stimulates the immune system. Exercise increases the number of natural killer cells that can kill cancer cells. „To promote immune competence, we should exercise intensively for at least 10 minutes higher every day and really work up a sweat to activate the muscles,“ explains Prof. Halle.
Healthy eating promotes good health
„However, the cancer-preventive effect of nutrition and individual foods should not be viewed in isolation. It only comes into effect in combination with exercise and a healthy lifestyle. Someone who eats well but smokes and does no exercise still has an increased risk of cancer,“ says nutritionist Dr. Nicole Erickson, coordinator for health literacy and e-health at the University Hospital of the Ludwig-Maximilians-University Munich.
The German Nutrition Society recommends a balanced mixed diet: at least 400 g of vegetables and 250 g of fruit a day, whole grain products, a maximum of 150 g of dairy products such as yoghurt and cheese a day. Fish once or twice a week, unprocessed meat 300-max. 600 g per week, little alcohol: 10 g per day (a small glass of wine) for women and 20 g per day (half a litre of beer) for men. Processed red meat is considered carcinogenic, especially cured and smoked sausages.
Bowel cancer prevention is an effective preventive measure with the immunological stool test and colonoscopy. „In the development of bowel cancer, we know of benign precursors, so-called bowel polyps. These can be removed during a colonoscopy. This prevents them from degenerating into cancer later on,“ says Dr. Berndt Birkner, specialist in gastroenterology, internist and trustee of the Felix Burda Foundation and vice-president of the Netzwerk gegen Darmkrebs e.V.
In order to prevent as many cases of bowel cancer as possible or to be able to detect them at an early and thus curable stage, however, many more insured persons would have to take advantage of the preventive and early detection measures offered by the health insurance funds than is currently the case. Taking an immunological stool test is a first important step towards preventing bowel cancer. If this test is positive and blood is found in the stool, the cause should be clarified by a colonoscopy by a gastrointestinal doctor.
For at-risk groups such as relatives of colorectal cancer patients – the familial risk group – participation in colorectal cancer screening is even more significant, as this risk group has a 4-8-fold increased risk of developing colorectal cancer compared to the average population.
Prevention of gynaecological cancers
The prevention and early detection of gynaecological cancers is very important, because about half of all cancers in women originate from gynaecology. Breast cancer, for example, is the most common cancer in women, with about 70,000 new cases every year. „Breast cancer mortality has been falling steadily since the 1990s because mammography detects many tumours at an early stage. But the early establishment of certified cancer centres also contributes to improved oncological care for women,“ explains Prof. Dr. med. Sven Mahner, Director of the Clinic and Polyclinic for Gynaecology and Obstetrics at the University Hospital of the Ludwig-Maximilians-University Munich.
With the introduction of the PAP smear test in 1971, the number of annual new cases of cervical cancer, the most common malignant tumour in young women, was reduced from 16,000 to 4,300 cases. „Vaccination against HPV is also a success story. With a high vaccination coverage rate among girls aged 9 to 14, we could reduce the number of new cases almost to 0 per cent,“ says Prof Mahner.
Consequential risk of fatigue
A study is evaluating the fatigue consultation of the Bavarian Cancer Society. It is planned for three years and analyses the services offered by the fatigue consultation hours in 10 psychosocial cancer counselling centres as well as the need for patients. Those affected often suffer from tumour-related fatigue, which can manifest itself, among other things, as great tiredness and exhaustion, sleep disturbances, loss of performance or depression.
„Around 30 percent of all cancer patients develop tumour-related fatigue, which puts a great strain on the lives of those affected,“ knows Dipl.-Psychologe Markus Besseler, Managing Director of the Bavarian Cancer Society. The study is funded by the Bavarian State Ministry for Family Affairs, Labour and Social Affairs and is scientifically accompanied by the Centre for Clinical Studies at the University Hospital Regensburg.
Prof. Dr. Renate Oberhoffer-Fritz
Dean of the Faculty of Sport and Health Sciences
Chair of Preventive Pediatrics
Georg-Brauchle Ring 60/62, 80992 Munich, Germany
Tel.: +49 89 289 24601 – E-Mail: firstname.lastname@example.org
Prof. Dr. Martin Halle
Chair of Preventive and Rehabilitative Sports Medicine
Georg-Brauchle-Ring 56 (Campus C), 80992 München
Tel.: +49 89 289 24441 – E-Mail: email@example.com
Comprehensive Cancer Center München
Dr. Lisa Koch
Geschäftsstelle des CCC München
Pettenkoferstr. 8a, 80336 Munich, Germany
Tel.: +49 89 4400 57430 – E-Mail: firstname.lastname@example.org
Anton Berns, Ulrik Ringborg, Julio E. Celis, Manuel Heitor, et.al.,
Towards a cancer mission in Horizon Europe: recommendations
Molecular Oncology, 14, 8, August 2020, 1589-1615 - DOI: 10.1002/1878-0261.12763
https://febs.onlinelibrary.wiley.com/doi/10.1002/1878-0261.12763 Recommendations on cancer prevention
https://cancer-code-europe.iarc.fr/index.php/en European Code Against Cancer
https://www.sg.tum.de/en/sg/news-en/article/aktiv-gegen-krebs-erfolgreiche-wege-um-das-krebsrisiko-zu-senken/ News release of the TUM-Faculty of Sport and Health Sciences
https://www.ccc-muenchen.de/ Website of the Comprehensive Cancer Center Munich