Smoking, alcohol, obesity and Men’s cancer

By: Dr. Indu Bansal Aggarwal

Cancer can affect any one of us, whether you’re a male, female, young, old, rich, poor, co-worker, doctor, or patient. The focus on cancer screening has always been around mammography but today let’s talk about men’s health. As per Cancer Statistics data 2020, the five most common causes of cancer in men are-lung, mouth, esophagus (food pipe), stomach and nasopharynx (tumor behind nose).The projected incidence of cancer in men for 2020 were 94.1/1 lakh men and 103.6/1 lakh in females. Risk of cancer in males before 75 yrs of age is 9.8% and mortality rate is 7.3%. 1 in 68 males are at risk of lung cancer, 1 in 29 females are at risk of breast cancer and 1 in 9 Indians are at risk of developing cancer in their lifetime. 

What to do?

Can we do something about it to prevent or lower this risk? It’s important to educate, prevent, screen, detect, treat, prolong life and improve the quality of life of men with cancer. Let’s remember that curing cancer starts with preventing cancer in the first place. It’s a very important part of solving the problem of cancer and let’s not forget that 70% of cancers are preventable through modifying risk factors.

Avoid Tobacco

Please note that the majority of the cancers above have a common cause and that is tobacco consumption in any form. More than one third of cancers are tobacco related. A tobacco smoke has 4000 chemicals and 60 of these are directly carcinogenic. Don’t forget that tobacco companies destroy their most loyal customer. You burn one end of the cigarette and your life and pocket burns at the other end. Tobacco products can cause cancer of 16 sites in the body. It’s responsible for all head and neck cancers, lung, esophagus, stomach, renal, urinary bladder, prostate, and even penile cancers. As compared to non-smokers, male smokers are 23 times and female smokers 17 times more likely to develop lung cancer. Please remember that the symptoms of lung cancer such as chronic cough, blood in spit, chest pain, bony pains don’t manifest till tumour has spread so all the more reason to avoid smoking.  So, the first and foremost step to prevent cancer is to avoid tobacco in all forms such as bidi, cigarette, rolled tobacco, areca nut, pan, supari, pan masala, e-cigarettes and stay away from second hand smoke as well.

Alcohol

Don’t exchange one addiction for the next and start drinking alcohol too. Don’t drink the poison, the advertising world pours all around us. If you have committed a mistake, don’t date it further.  An average smoker smokes 11 cigarettes per day. And many people who smoke also drink alcohol and have a fried and non- vegetarian diet along with it leading to obesity. So, all these increase cancer risk even further. Remember if you consume tobacco and alcohol both then the risk of oral cancers increases to 24% as compared to 7% with either alone. Drinking 3 bottles of wine per week is roughly equal to 8 cigarettes for men and 23 for women. All types of alcoholic drinks, including red and white wine, beer, cocktails, and liquor, are linked with cancer. The more you drink, the higher your cancer risk. Alcohol is responsible for 5.5% of all cancers and cancer of 7 sites in the body such as mouth, pharynx, stomach, bowel, liver and breast. So go sober and be stronger than your greatest excuse. 

Early Detection as Best Protection

Also, the best protection is early detection. So all men who smoke or take alcohol, should self -examine their mouth and oral cavity. Stand in front of a mirror and check for any white or red patches on the gum, cheeks, tonsils and sides or under the surface of the tongue to rule out cancer of the oral cavity.  Also, please don’t ignore any ulcers, growth or induration in any of these areas. Please don’t ignore symptoms such as persistent cough, shortness of breath, hoarseness of voice, blood in sputum or noisy breathing. These can be symptoms of lung cancer. A simple chest X ray or a low dose helical CT scan of the chest can detect lung cancer early. 

It’s also important to look for any lumps (which may or may not be painful) on neck, armpits, groin to rule out enlargement of lymph nodes which may happen in cases of lymphoma, a type of blood cancer. Any thickening, lump or induration anywhere on the body should be investigated and even under the skin or muscles should be examined to rule out sarcomas.  Don’t ignore any unusual blood through nose, mouth, sputum, vomit, urine or in stools. If there is unexplained weight loss, unusual fever or difficulty in swallowing please consult a physician.  Also, if there is any change in colour or size of any mole or nevus or if it bleeds, consult a skin specialist to rule out skin cancer. Men need sunscreen too with at least SPF of 30 and try to avoid harsh UV rays between 11AM-4 PM to prevent skin cancer. 

All men between ages of 15-34 years of age should examine their testicles for any lump and if they find any abnormality please don’t shy away but see a doctor immediately as young men are at risk of testicular cancer which can be easily detected and is a curable tumor. All men should start getting the blood levels of PSA checked once in a year after 50 years of age to detect prostate cancer. It’s normal value is <4 ng.ml. It’s a walnut shaped gland which sits at the neck of the urinary bladder and produces semen. If there is enlargement of the prostate gland it can lead to increased frequency of urine, urinary hesitancy, thinning of stream, incomplete evacuation and blood in urine or semen. It’s a simple and inexpensive blood test which can detect prostate cancers very early. Men with a first degree relative diagnosed with prostate cancer at < 65 years should start the test early at 45 years of age and with more than 1 relative should start getting it done at 40 years of age. Men who choose to be tested who have a PSA of < 2.5 ng/ml may need to be retested every 2 years. Screening should be done yearly for men whose PSA is 2.5ng/ml or higher.

Stay lean.

Obesity increases the risk of cancer by 18-20%. Your unhealthy food is much cheaper to buy but more costly to your health. Eat a healthy diet and avoid saturated fat and red meat. Unhealthy diet increases the risk of cancer by 35%. It’s better to go the green way and increase intake of coloured fruits, vegetables, fibre and whole grain.

Don’t be a munching couch potato. Move. Please exercise regularly. Regular physical activity decreases the risk of breast, prostate and colon cancer. 1% of men can develop breast cancer too. The only bad workout is one which does not happen. It’s better to have a new hangover of muscle soreness. 

Avoid Toxins

If possible, avoid exposure to industrial and environmental toxins such as asbestos, benzene, aromatic amines. Get vaccinated for Hepatitis B to prevent liver cancer. Soon, we will have a vaccine in the Universal immunisation program called Gardasil 9, against Human Papillomavirus. It’s to be given to all men between 9-26 years of age to protect against oral cancers, anal cancers, penile cancers, ano-genital warts and sexually transmitted diseases.  

It’s important to get routine blood work up as complete blood count, liver and kidney function tests ,Lipid profile, X-ray chest PA view and USG whole abdomen at least once a year after 40 years of age. Low levels of Haemoglobin may detect blood cancers, stomach cancer or multiple myeloma. 

We want you to be healthy. Remember your health is in your own hands.  Don’t keep on sitting in the passenger seat of your life. Take the wheel of health in your hand. Adopt a healthy lifestyle. Don’t ignore any symptoms and go for preventive health check-ups.  Stay stress free. Look your handsome best always. Carry your soul in your smile. Dress your future and change the narrative. Because I know YOU CAN!

About the Author:

Dr. Indu Bansal Aggarwal is working as Director and Senior Consultant, in the Department of Radiation Oncology at Narayana Superspeciality Hospital, Gurgaon. She has done Fellowship from world renowned MD Anderson Cancer Centre, Houston, Texas. She has more than 22 years of experience and has worked in best Oncology hospitals as Rajiv Gandhi Cancer Hospital, Batra Hospital, Max Super Speciality Hospital, Saket, and Artemis Hospital, Gurgaon. She has co-authored various book chapters and has numerous publications to her credit in National and International journals. She is the Chief Editor of Asian Society of Cardio Oncology newsletter. She has been chosen as Pink Ambassador for Global Enterpreneurs Cloque to create awareness about cancer. She is an invited speaker at various national and international conferences of repute. She has many awards to her credit as “Best oncologist of Gurgaon” by Times research Group, National Mahila Rattan Gold Medal award, Rajiv Gandhi Excellence Award etc. to name a few. She has various articles in leading English and Hindi magazines and newspapers. She has done hundreds of School and community awareness programs to create awareness about cancer and for its early detection.

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