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如何預防癌症?

  作者:美國脊柱放射學會,美國神經放射學會,紐約長老會醫院Dr Ananya Mandal, MD

  癌症風險與個人基因及暴露於多種環境毒素相關。有些特定的風險因素是不可改變的(例如基因遺傳因素),然而一些生活方式的因素如果我們改正是可以幫助預防癌症發生。

  另一個預防癌症的重要措施是及時了解自己的身體,提高通過體檢方式儘可能早的發現可疑的癌症的意識。

  一個健康的生活方式能夠降低某些癌症的發病風險。包括以下一些措施:

  吃健康的食物和平衡膳食

  目前,有許多研究都涉及到哪些食物能夠增加或降低癌症風險,然而沒有一種單一的食物或者營養補充劑能夠阻止癌症的發生。總體而言,研究揭示了食用特定類型的食物和減少癌症發生率的關係。

  健康的飲食包括大量的水果和蔬菜(每天至少5份),大量的穀物,大米,土豆,麵食以及其他富含碳水化合物的食物,特別是那些含有粗纖維的食物。

  食用足夠的纖維素可以減少腸癌的發生率。纖維素豐富的食物包括全麥的麵食,麵包,早餐麥片,大米。豆子,水果,蔬菜也是好的纖維素的來源。

  我們也應該吃一些魚類,雞蛋,豆類和其他非奶製品的蛋白質,也應包括一定量的牛奶和乳製品食物。雖然肉類是很好的蛋白質,維他命和礦物質的來源,例如:鐵,鋅,但有證據顯示過多使用加工過得紅肉會增加罹患腸癌的風險。紅肉包括牛肉,豬肉,羊肉和加工好的肉類,包括培根,臘腸,義大利香腸和火腿。飲食應該只包括小量的含有高脂肪和糖類的食物和飲料。

  飲食中應該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風險。例如:β-葫蘿蔔素,常見的抗氧化營養補充劑,已經被被發現對於吸煙者和嚴重暴露於石棉的工作者,具有增加肺癌風險的作用。

  保持健康和正常的體重

  過高的體重,肥胖和超重會增加一些腫瘤的風險,包括腸癌,胰腺癌,食道癌,腎癌和乳腺癌。

  完全戒煙

  90%肺癌與吸煙有關。吸煙在預防肺癌發生方面是單一最重要的可預防的因素。因此越早戒煙對於癌症的預防越有利、

  減少飲酒量

  過度飲酒和口腔癌,喉癌,咽癌(口腔和後鼻孔與喉和食管之間的肌膜性通道),腸癌(尤其是男性),肝癌和乳腺癌(特別是女性)。女性每天規律地飲酒不應超過2-3個單位,男性每天規律地飲酒不應超過3-4個單位。

  防止長期將裸露的暴露於陽光下

  皮膚癌是白種人中常見的癌症,特別是那些長期暴露與太陽紫外線下的人。一些措施包括在上午11點到下午3點間置身於陰涼處,塗抹具有阻擋紫外線功能的防晒霜,通過衣服,帽子和太陽鏡遮蓋身體暴露於陽光的部分。

  密切關注自己身上的任何痣(痦子),雀斑。這些痣(痦子),雀斑的任何改變都需要到醫院進行就診。這些跡象表徵包括痣(痦子)越長越大或者開始出血等等。

  通過使用安全的防護措施,預防性傳播疾病

  這個措施能夠阻斷丙型肝炎和人類乳頭狀瘤(HPV)的傳播。前者是肝癌的誘因,而活著是子宮頸癌的誘因。

  防止暴露於環境致癌因素之中

  那些工作在輻射和石棉環境中的工人,工作場所的安全性至關重要。暴露於輻射和化學物質如:苯,可以導致白血病,而暴露於石棉纖維環境中可以導致肺癌如:間皮瘤。

  預防癌症的藥物

  有些臨床試驗已經在這一方面取得成功。每天使用他莫昔芬(三苯氧胺),一種選擇性雌激素受體調節劑(SERM),通常是5年時間,已經被證明能減少高風險婦女乳腺癌發病大約50%。雷洛昔芬是一種雌激素拮抗藥,像他莫昔芬一樣,它已經顯現出和他莫昔芬一樣的減少高風險婦女乳腺癌發病的功能。

  對於癌症預防的疫苗

  預防人類乳頭癌病毒和乙肝的疫苗已經研製成功。這些能夠治療宮頸癌(對抗人類乳頭癌病毒的藥物—加德西[子宮癌疫苗]和Cervarix疫苗)和肝癌。

  篩查

  癌症掃描是一項在無癥狀的人群中發現未被察覺的癌症的嘗試。這些檢查通常在一定年齡後被應用到健康個體上。對於癌症的篩查使得對特定癌症早期診斷成為可能,早期診斷可以延長生命。

  最好的因為篩查而受益的例子包括通過乳房X線照片篩查乳腺癌,對於結腸癌通過便潛血測試和結腸鏡檢查術,對於宮頸癌通過常規篩查子宮頸癌塗片試驗對子宮頸細胞進行篩查。

  基因檢測

  對於特定癌症相關基因突變為高風險人群的提供基因檢測已經成為可能。一些種類的癌症具有特定的基因突變特徵。這包括例如像BRCA1和BRCA2基因對於乳腺,卵巢和胰腺癌,MLH1,MSH2,MSH6,PMS1.PMS2對於子宮,結腸,小腸,胃癌和泌尿道癌症。

  Reviewed byApril Cashin-Garbutt, BA Hons (Cantab)

  本文來源於美國news-medical網站,作者紐約長老會醫院Dr Ananya Mandal, MD,由全球腫瘤醫生—環宇達康醫療編譯,轉載必須註明出處!未註明出處轉載,全球腫瘤醫生—環宇達康醫療保留追究法律責任的權利!

  原始網址:http://www.news-medical.net/health/How-to-Prevent-Cancer.aspx

  注釋:關於預防癌症的文章,涉及基因檢測及眾多患者和家屬關心的問題。

  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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