What to do if you are healthy or get cancer

Published on 15/05/2003 01:00

Give up smoking and if you are a young female, give up smoking yesterday. Smoking contributes to 30 per cent of all cancers, including cancers of the bladder, cervix, throat, kidney and mouth. It is responsible for 90 per cent of lung cancer, which kills one person every 15 minutes in the UK. The incidence is still rising in women. Giving up smoking, on average, adds three years to your life. Most chemotherapy drugs cannot match that result.

Change your diet. A third of all cancers have links to diet. The World Health Organisation has just published a report confirming that fruit and vegetables consumption reduces the risk of cancer of the lung, stomach and oesophagus. The WHO working group estimates that one in ten cancers in Western Europe is due to insufficient amounts of fruit and vegetables in the diet. The figure is likely to be much higher in Scotland, home of the deep-fried everything.

Exercise. Cancers of the breast and uterus have been linked to obesity in post-menopausal women and regular exercise may protect against cancer of the bowel and kidneys. One of the problems some cancer patients face is that they are not fit enough to undergo the most effective treatments. "You can't give an unfit lady with ovarian cancer in West Lothian, the treatment you would give to a social class one person in Holland because she will die of toxicity," says Dr Anna Gregor, lead cancer clinician for Scotland.

Reduce your alcohol intake. Heavy drinking can cause cancer of the mouth, throat and oesophagus. It may also be a risk factor for breast cancer. Alcoholics have an increased risk of getting cancer of the liver, pancreas and bowel.

Apply sun tan lotion. There are 46,000 new cases of skin cancer each year in Britain and the numbers are rising. Most are curable but many are preventable.

Don't be shy. In general the earlier the diagnosis, the better the prognosis. The prospects for breast, skin, testicular and bowel cancer, in particular, are much better if caught early. Suspicious changes in those organs should be reported to your GP immediately. 15,000 Scots die of cancer each year. So far nobody has died of embarrassment.

Go for screening. There is great controversy about the value of screening programmes, although the Swedes, who have some of the best cancer statistics in the world, say their breast cancer deaths have dropped by half following the introduction of a routine screening programme. In Scotland we screen for breast and cervical cancer. There are pilot schemes screening for bowel cancer in Fife, Tayside and Grampian which are expected to be rolled out nationwide. Some experts feel screening catches too few cases to justify the cost. If you are one of the few that doesn't tend to be an issue.

Chose your parents carefully Between 5 and 10 per cent of cancer is caused by faulty genes inherited from one or both parents. If half your aunts and uncles on one side of the family have died young from a particular cancer, alarm bells should be ringing. Get your GP to refer you to a specialist cancer genetics clinic where you can be offered advice on screening, prevention and possible genetic testing.

Move to a big city. John Smyth, professor of oncology at Edinburgh University, says: "If you choose to live on one of the islands your local medical access is not going to be as good as if you choose to live in Edinburgh or Glasgow". The new system of managed clinical networks is designed to eradicate geographical inequality in cancer care. It won't happen overnight, however.

Consider health insurance. In Scotland very little cancer care is carried out in the private sector but for some, it can mean the option of being treated at home. It can also mean getting new or expensive cancer drugs, which are sometimes rationed, on the NHS. It may allow you to jump queues. Private medicine doesn't mean better medicine, however, and private health insurance which covers cancer may not be cost effective for individuals. If a policy is available through work, it could be worth having though.

Be involved. Find out if your local health board offers multi-disciplinary team care for cancer and find out if it waiting times in your area are in line with national recommendations. If not, ask why. Attend the AGM and be persistent.

Be lucky You can do all of the above and still get cancer. One of the main causes of cancer is bad luck. It's not your fault.

Don't worry Whatever it is you've got, the chances are that it isn't cancer. 75 per cent of us will die from something else.