How to prevent cancer

I am often asked by Ezra customers whether cancer is preventable. The good news is that most cancers are preventable and, if detected early, they are also curable. This post covers all the science-backed lifestyle interventions you can make in order to prevent cancer and reduce your risk of dying from the disease.

What is cancer?

Before we cover cancer prevention, let's gain a bit of understanding of what cancer is, and how it forms. Cancer formation is a process that begins with mutations in the DNA of a single cell. These mutations can be inherited (i.e. genetic predisposition) or acquired over time due to factors like environmental exposures or errors during cell division. The mutations cause changes in genes that control cell growth and division, allowing the abnormal cell to proliferate uncontrollably (i.e. oncogene formation). As the mutated cell continues to divide, it gives rise to a population of abnormal cells that form a tumor. Further mutations accumulate in these tumor cells, conferring selective advantages like increased growth rate, invasion into surrounding tissues, and ability to metastasize to distant sites. This progressive acquisition of genetic alterations drives the transition from a benign tumor to a malignant, invasive cancer.

While there is not much we can't do about inherited genes that increase our risk, we can certainly apply lifestyle interventions to reduce our exposure to developing cancer.

Preventing cancer

1. Don't use tobacco products

Smoking cigarettes, cigars, vaping, and tobacco use in any form is attributed to 30% of all cancer-related deaths. And it's not just lung cancer. Tobacco use leads to increased risk of lung cancer, mouth cancer, esophageal cancer, pancreatic cancer, bladder cancer, cervical cancer, kidney cancer, and more.

2. Don't drink alcohol

Alcohol increases the risk of multiple types of cancer, including breast, lung, kidney, liver, and colon cancers. Recent studies have shown that alcohol consumption, even in small quantities of one to two drinks per day, can raise the risk of some types of cancer.

According to guidelines from the American Cancer Society, it's best to avoid alcohol altogether. People who drink alcohol should limit their intake to no more than two drinks per day for men and one drink a day for women.

3. Eliminate processed meats from your diet

The International Agency for Research on Cancer (IARC) has classified processed meat as "carcinogenic to humans" (Group 1) based on sufficient evidence that it causes colorectal cancer. This puts processed meat is in the same carcinogenic group as cigarettes and tobacco products.

And it's not just processed meat, it's any type of red meat. People who eat a diet heavy in processed and red meats are at increased risk of colon, liver, and other gastrointestinal cancers.

4. Exercise vigorously

It will come as no surprise that regular exercise is associated with a lower risk of developing certain cancers, including breast, colon, endometrial, kidney, bladder, esophageal, stomach, and lung cancer.

One study has found that getting 7.5 - 15 MET hours per week (equivalent to 2.5 - 5 hours of moderate activity) lowered the risk of several cancers by 8-18% compared to being inactive.

5. Maintain a healthy weight

About 4-8% of all cancers globally are attributed to excess body weight or obesity. In the U.S., it is estimated that obesity accounts for 4.7% of new cancer cases in men and 9.6% in women. Even worse, the risk of cancer increases progressively the more overweight a person is. For some cancers like endometrial cancer, the risk is 7 times higher in people with severe obesity compared with those with normal weight.

The research also shows that intentional weight loss, even by relatively modest amounts, can have an impact on reducing future cancer risk.

My experience has been that the best way to lose weight sustainably is a slight caloric deficit (~10% of your daily caloric expenditure), and exercise. I've written about this topic in more detail in my longevity protocol and workout protocol.

6. Supplement with Omega-3, Vitamin-D, and Magnesium

Omega-3 fatty acids, particularly EPA and DHA, have anti-inflammatory, anti-proliferative, and pro-apoptotic effects that could inhibit tumor growth and metastasis. Data is limited and more clinical evidence is needed, but at least one study shows improved clinical outcomes in chemotherapy patients who supplement with Omega-3.

Magnesium is a key micronutrient that helps regulate oxidative stress, inflammation, DNA repair, cell proliferation, and insulin sensitivity. We covered earlier in this essay that cancer is primarily a genetic disease, thus lower levels of inflammation and DNA repair mechanisms are essential. More studies are needed, but recent research has shown that magnesium intake can reduce the risk of pancreatic, liver, colon, and breast cancer.

Vitamin-D plays a role in modulating the immune system, which could provide protection against cancer. More data is needed, but some observational studies have shown that Vitamin D slows down progression of cancer in cancer patients.

In summary, correlation is not causation and without comprehensive randomized clinical trials we cannot conclude with confidence that supplementation with Omega-3, Magnesium, and Vitamin-D reduces our risk of developing cancer. However, one can reason that reduced inflammation, DNA repair, and a healthier immune system can contribute to reducing risk of cancer.

7. Wear sunscreen and don't use tanning beds

Several large randomized controlled trials have found that regular sunscreen use can reduce the risk of melanoma, the most dangerous form of skin cancer, and squamous cell carcinoma, a major form of non-melanoma skin cancer.

That said, it's important that you use sunscreen while also avoiding sun exposure. One observational study has shown that use of sunscreen could increase melanoma risk, possibly due to people spending more time in the sun.

When it comes to which sunscreen to use, there is strong consensus that broad spectrum UVA and UVB blocking sunscreen with SPF factor of 30 or higher is ideal. I use the Elta MD broad-spectrum SPF 30+.

While we're on the skin cancer topic, you should avoid tanning beds at all costs. Those who use tanning beds have a 75% higher risk of developing melanoma than those who don't.

8. Avoid exposure to industrial toxins

Studies have linked specific chemicals like benzene, ethylene oxide, formaldehyde, dioxins, and others to elevated risk for bladder, lung, leukemia, laryngeal and other forms of cancer.

More recent research is also starting to show a relationship between various plastic materials and cancer. PVC microplastic dust increase risk of lung cancer, BPA (a chemical used in plastics) increases risk of breast cancer, DEHP increases risk of several cancers, and microplastics and nanoplastics could cause DNA damage leading to carcinogenesis. More data is needed, but it is probably best to try to avoid the use of plastic in your environment.

9. Get vaccinated

If you're a woman, you should absolutely get an HPV vaccine. A large scale HPV vaccination program in Sweden led to a reduction in cervical cancer incidence by 90% in the vaccinated population.

10. Get screened for cancer

The list above covers all the things you can do in order to reduce your risk for cancer. But given that cancer is a genetic disease that originates with a series of genetic mutations, you can also get unlucky.

To best mitigate the risk of dying from cancer, you should also be aggressive about screening. I've written about screening at length in my longevity protocol, but in summary my current recommendations are:

• Women over 25 should get a pap smear every year to screen for cervical cancer
• Everyone of 25 should get an annual dermatology check for melanoma
• Everyone over 30 should get an annual Full Body MRI with Ezra (disclaimer: I'm the founder & CEO)
• All women over 40 should get a mammogram every year (for high risk, start with a baseline mammogram at 35)
• Everyone over 40 should get a colonoscopy every 5 years (for high risk, start at 38)
• Smokers or former smokers over 40 should get a low-dose chest CT with Ezra every 2 years

I'm aware that this is a long list. But I do believe that in order to make cancer non-lethal in the world we need to invest in prevention and early detection. According to the American Cancer Society, 80% of those who find cancer early survive longer than 5 years, compared to only 20% of those who discover cancer late.

I hope this list helps you and your loved ones avoid cancer altogether and, in the event that you do develop cancer, I hope you screen aggressively in order to detect it as early as possible.