作者:美国脊柱放射学会,美国神经放射学会,纽约长老会医院Dr Ananya Mandal, MD
癌症风险与个人基因及暴露于多种环境毒素相关。有些特定的风险因素是不可改变的(例如基因遗传因素),然而一些生活方式的因素如果我们改正是可以帮助预防癌症发生。
另一个预防癌症的重要措施是及时了解自己的身体,提高通过体检方式尽可能早的发现可疑的癌症的意识。
一个健康的生活方式能够降低某些癌症的发病风险。包括以下一些措施:
吃健康的食物和平衡膳食
目前,有许多研究都涉及到哪些食物能够增加或降低癌症风险,然而没有一种单一的食物或者营养补充剂能够阻止癌症的发生。总体而言,研究揭示了食用特定类型的食物和减少癌症发生率的关系。
健康的饮食包括大量的水果和蔬菜(每天至少5份),大量的谷物,大米,土豆,面食以及其他富含碳水化合物的食物,特别是那些含有粗纤维的食物。
食用足够的纤维素可以减少肠癌的发生率。纤维素丰富的食物包括全麦的面食,面包,早餐麦片,大米。豆子,水果,蔬菜也是好的纤维素的来源。
我们也应该吃一些鱼类,鸡蛋,豆类和其他非奶制品的蛋白质,也应包括一定量的牛奶和乳制品食物。虽然肉类是很好的蛋白质,维他命和矿物质的来源,例如:铁,锌,但有证据显示过多使用加工过得红肉会增加罹患肠癌的风险。红肉包括牛肉,猪肉,羊肉和加工好的肉类,包括培根,腊肠,意大利香肠和火腿。饮食应该只包括小量的含有高脂肪和糖类的食物和饮料。
饮食中应该多食用抗氧化的食品。然而,一些抗氧化食物如果大量食用也可能增加癌症的风险。例如:β-葫萝卜素,常见的抗氧化营养补充剂,已经被被发现对于吸烟者和严重暴露于石棉的工作者,具有增加肺癌风险的作用。
保持健康和正常的体重
过高的体重,肥胖和超重会增加一些肿瘤的风险,包括肠癌,胰腺癌,食道癌,肾癌和乳腺癌。
完全戒烟
90%肺癌与吸烟有关。吸烟在预防肺癌发生方面是单一最重要的可预防的因素。因此越早戒烟对于癌症的预防越有利、
减少饮酒量
过度饮酒和口腔癌,喉癌,咽癌(口腔和后鼻孔与喉和食管之间的肌膜性通道),肠癌(尤其是男性),肝癌和乳腺癌(特别是女性)。女性每天规律地饮酒不应超过2-3个单位,男性每天规律地饮酒不应超过3-4个单位。
防止长期将裸露的暴露于阳光下
皮肤癌是白种人中常见的癌症,特别是那些长期暴露与太阳紫外线下的人。一些措施包括在上午11点到下午3点间置身于阴凉处,涂抹具有阻挡紫外线功能的防晒霜,通过衣服,帽子和太阳镜遮盖身体暴露于阳光的部分。
密切关注自己身上的任何痣(痦子),雀斑。这些痣(痦子),雀斑的任何改变都需要到医院进行就诊。这些迹象表征包括痣(痦子)越长越大或者开始出血等等。
通过使用安全的防护措施,预防性传播疾病
这个措施能够阻断丙型肝炎和人类乳头状瘤(HPV)的传播。前者是肝癌的诱因,而活着是子宫颈癌的诱因。
防止暴露于环境致癌因素之中
那些工作在辐射和石棉环境中的工人,工作场所的安全性至关重要。暴露于辐射和化学物质如:苯,可以导致白血病,而暴露于石棉纤维环境中可以导致肺癌如:间皮瘤。
预防癌症的药物
有些临床试验已经在这一方面取得成功。每天使用他莫昔芬(三苯氧胺),一种选择性雌激素受体调节剂(SERM),通常是5年时间,已经被证明能减少高风险妇女乳腺癌发病大约50%。雷洛昔芬是一种雌激素拮抗药,像他莫昔芬一样,它已经显现出和他莫昔芬一样的减少高风险妇女乳腺癌发病的功能。
对于癌症预防的疫苗
预防人类乳头癌病毒和乙肝的疫苗已经研制成功。这些能够治疗宫颈癌(对抗人类乳头癌病毒的药物—加德西[子宫癌疫苗]和Cervarix疫苗)和肝癌。
筛查
癌症扫描是一项在无症状的人群中发现未被察觉的癌症的尝试。这些检查通常在一定年龄后被应用到健康个体上。对于癌症的筛查使得对特定癌症早期诊断成为可能,早期诊断可以延长生命。
最好的因为筛查而受益的例子包括通过乳房X线照片筛查乳腺癌,对于结肠癌通过便潜血测试和结肠镜检查术,对于宫颈癌通过常规筛查子宫颈癌涂片试验对子宫颈细胞进行筛查。
基因检测
对于特定癌症相关基因突变为高风险人群的提供基因检测已经成为可能。一些种类的癌症具有特定的基因突变特征。这包括例如像BRCA1和BRCA2基因对于乳腺,卵巢和胰腺癌,MLH1,MSH2,MSH6,PMS1.PMS2对于子宫,结肠,小肠,胃癌和泌尿道癌症。
Reviewed byApril Cashin-Garbutt, BA Hons (Cantab)
本文来源于美国news-medical网站,作者纽约长老会医院Dr Ananya Mandal, MD,由全球肿瘤医生—环宇达康医疗编译,转载必须注明出处!未注明出处转载,全球肿瘤医生—环宇达康医疗保留追究法律责任的权利!
原始网址:http://www.news-medical.net/health/How-to-Prevent-Cancer.aspx
注释:关于预防癌症的文章,涉及基因检测及众多患者和家属关心的问题。
英文原文:
1.How to Prevent Cancer
ByDr Ananya Mandal, MD
Cancer risk is related to genes and exposure to several environmental toxins. While certain risks are un-changeable (genes for example), some lifestyle factors if modified may help prevent the occurrence of cancer.
Another important measure for prevention of cancer is by knowing one’s own body and being aware of any changes to detect a possible cancer as early as possible.
A healthy lifestyle can lower the risk of certain cancers. This includes several measures like:
Eating a healthy and balanced diet
There is a lot of research on what raises cancer risk and what reduces it, however, no single food or supplement can prevent cancer from developing. Overall, research shows a link between eating certain groups of foods and a reduction in cancer risk.
Healthy diet includes plenty of fruit and vegetables (at least 5 portions a day), plenty of bread, rice, potatoes, pasta and other foods with carbohydrates and especially those with fiber.
Eating enough fiber reduces the risk of bowel cancer. Fibre-rich foods include wholegrain pasta, bread, breakfast cereals and rice. Pulses, fruit and vegetables are also good sources of fibre.
There should be some meat, fish, eggs, beans and other non-dairy sources of protein as well as some milk and dairy foods in diet. Although meat is good source of protein, vitamins and minerals, such as iron and zinc, there is evidence that too much of red processed meat can be bad as it may raise risk of bowel cancer. Red meat includes beef, pork and lamb and processed meat includes bacon, sausages, salami and ham. Diet should contain only small amounts of foods and drinks high in fat or sugars.
Diet should be high in foods with antioxidants. However, some of these in high amounts may raise the risk of cancers. For example, Beta-carotene, often found in antioxidant supplements, has been found toincrease the risk of lung cancerdeveloping in smokers and people who have been heavily exposed to asbestos at work.
Maintaining a healthy and normal body weight
High body weight, obesity and being overweight raises the risk of several cancers including bowel cancer, pancreas cancer, esophagus cancer, kidney cancer and breast cancer.
Stopping smoking completely
90% of lung cancer cases are related to smoking. It is the single most important preventable factor in prevention of lung cancer. The earlier smoking is stopped the better it is.
Consuming less alcohol
Excessive alcohol consumption is linked to oral cancer, cancer of the voice box (larynx) or pharynx (back of the mouth), bowel cancer (especially in men), liver cancer and breast cancer (in women). Women shouldn't regularly drink more than 2-3 units of alcohol a day, and men shouldn't regularly drink more than 3-4 units a day.
Preventing prolonged exposure of bare skin to the sun
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Skin cancers are common among Caucasians who are exposed to the sun’s ultraviolet rays for long durations of time. Some measures include spending time in shade between 11am and 3pm, using sun screen lotions with sun protection factor (SPF) of at least 15, covering up exposed parts of the body with cloths, hats and sunglasses.
All are advised to keep a watch on any moles or freckles that they have. Any changes in these need to be investigated. This could be signs such as the mole getting bigger or begin bleeding etc.
Prevention of sexually transmitted disease by using safe sex measures
This can prevent transmission of Hepatitis C and Human Papilloma Virus (HPV). The former is responsible for liver cancers while the latter for cervical cancers.
Prevention of exposure to environmental factors
Work place safety among those who work with radiation and with asbestos is important. Exposure to radiation and chemicals like benzene may cause leukemias while exposure to asbestos fibers may lead to lung cancers like mesothelioma.
Drugs for prevention of cancer
Some trials have shown success in this respect. Daily use of tamoxifen, a selective estrogen receptor modulator (SERM), typically for 5 years, has been demonstrated to reduce the risk of developing breast cancer in high-risk women by about 50%. Raloxifene is a SERM like tamoxifen; it has been shown (in the STAR trial) to reduce the risk of breast cancer in high-risk women equally as well as tamoxifen.
Vaccines for cancer prevention
Vaccines against HPV and Hepatits B are available. These can protect against cervical cancer (against HPV – Gardasil and Cervarix) and liver cancers.
Screening
Cancer screening is an attempt to detect unsuspected cancers in an asymptomatic population. These are applied to healthy individuals usually after a certain age. Screening for cancer can lead to earlier diagnosis in specific cases. Early diagnosis may lead to extended life.
Best examples of benefits due to screening include screening for breast cancer by mammograms, for colon cancers through fecal occult blood testing and colonoscopy and for cervical cancers through regular Pap smears for cervical cytology.
Genetic testing
Genetic testing for high-risk individuals is already available for certain cancer-related genetic mutations. Some cancers are typified by certain genetic features. This includes examples like BRCA1 and BRCA2 genes for breast ovarian and pancreatic cancers MLH1, MSH2, MSH6, PMS1, PMS2 for colon, uterus, small bowel, stomach and urinary tract cancers.
Reviewed byApril Cashin-Garbutt, BA Hons (Cantab)
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