February 18 2025
Written by Eva Villalba, an NRG Oncology Patient Advocate Committee Member
February is Cancer Prevention Month, a time to highlight the importance of preventative measures in reducing cancer rates. I’ve been working as a Patient Advocate since 2008, and am the Executive Director of one of the most influential Patient Advocacy groups in Canada, the Quebec Cancer Coalition, where we have been working tirelessly to improve the lives of people affected by cancer but also to reduce avoidable cancers, raise awareness and advocate for effective cancer prevention strategies.
Cancer prevention involves taking proactive steps to reduce the risk of developing cancer including mitigating environmental risk factors, proactively adopting a healthier lifestyle, and medical interventions. I’ve been advocating for a comprehensive approach that includes public education, policy change, and community engagement and I’ll describe a few concrete examples in this article.
Cancer Prevention & the Environment
In February 2024, the Quebec Cancer Coalition organized a Symposium on Avoidable Cancers & Environmental Risk Factors in Montreal, Canada and brought together experts to discuss the latest research and strategies for mitigating these risks. We discussed the role of UV radiation, Radon and Air, Water and Soil Pollution (including pesticides) in causing and/or contributing to certain preventable cancers like skin cancer, lung cancer, hematological cancers, and digestive cancers. We worked with Patient Advocates and Patient Associations in these areas, as well as leading researchers and clinicians to determine tangible recommendations to take action and reduce the impact of these risk factors, ultimately reducing future incidence of these avoidable cancers.
The conference emphasized the need for stricter regulations on pollutants, better monitoring of radon levels in homes, and increased public awareness about the impact of UV radiation, as well as further research into the causal links and mechanisms between certain factors and developing cancer. Through continued advocacy and collaboration with patient groups, regulators, health systems, clinicians and researchers, our Coalition aims to create safer environments that reduce cancer risks.
Skin Cancer Prevention: A Tangible Goal
Skin cancer is one of the most frequent, yet underreported types of cancer. Luckily, it has a relatively good prognosis, except for advanced stage melanoma, but did you know that it is 90% avoidable through UV protection? And yet the rates have actually been going up instead of down in the last 15 years. Outdoor workers and people who have had 5-7 sunburns before the age of 35 are the most at risk. All we need to do is improve awareness about sun safety and UV protection. Wearing good quality SPF sunscreen is important, but being aware of the UV index, seeking shade when it’s at it highest, and wearing UV protective clothing also play a vital role. In Quebec, we worked with a patient partner who developed two melanomas before the age of 40 to launch a massive public awareness campaign amongst the public, but also outdoor workers such as construction workers and lifeguards. We also worked with one of our member organizations, the Save Your Skin Foundation, to raise awareness amongst municipalities about Sun Safety in their parks, public pools and with their outdoor workers. We are now in talks with the Ministry of Labor to add an amendment to the Labor Code so that outdoor workers are provided with some UV protective clothing, just like they get construction helmets and steel-toe boots to protect construction workers.
Tanning beds are also an avoidable cause of many skin cancers. Starting in 2011, many provinces in Canada banned tanning beds for people under 18, because they were most at risk of developing skin cancer after repeated use. In Brazil and Australia, they have been totally banned since 2009 and 2015. The rising rates in melanoma in people under 40 in many countries can often be linked with excessive childhood or young adult use of tanning beds.
The Role of Healthy Lifestyle Choices: Exercise, Nutrition, and Sleep
Lifestyle choices play a significant role in cancer prevention. Regular exercise, a balanced diet, and adequate sleep are essential components of a healthy lifestyle that can reduce cancer risk and improve overall well-being. The Quebec Cancer Coalition has been actively promoting these aspects through various campaigns and programs.
In Western countries, there is a rising incidence of Colorectal, Breast cancer and other gastrointestinal cancers in people under 50, and this has been linked to poor diet, a sedentary lifestyle and being overweight. Smoking and excessive alcohol consumption can also contribute significantly to the risk of developing many cancers, including lung, liver, esophageal, pancreatic and bladder cancer. Poor nutrition and eating processed foods lead to increased risk of colorectal, stomach, and pancreatic cancers.
Educational workshops and community fitness events are organized to encourage people to incorporate physical activity into their daily routines. Nutrition seminars focus on the importance of a diet rich in fruits, vegetables, and whole grains while minimizing processed foods and red meat. Additionally, the Coalition raises awareness about the importance of good quality sleep in maintaining a healthy immune system and reducing cancer risk.
Vaccination, Proactive Medical Interventions & Early Detection
Human papillomavirus (HPV) is linked to nine types of cancers, and vaccination is a powerful tool in preventing these cancers. Did you know that it is the only vaccine that exists to prevent cancers? It is not only the main cause of cervical cancer, which the World Health Organization (WHO) aims to eradicate globally by 2030, but it is also responsible for about 70% of head & neck cancers (throat, tongue, tonsils), anal cancer, penile cancer, vulvar cancer and vaginal cancer. With 80-90% of the population being infected by HPV in their lifetime, this is an opportunity to stop cancer before it starts in a really significant way.
Our organization has been at the forefront of efforts to promote HPV vaccination, especially among adolescents and young adults, with our member organization, HPV Global Action. We worked together with our member organization and patient partners to get HPV Vaccination offered by the public health care system in public high schools, thus dramatically reducing the rates of the 9 types of cancer associated with HPV.
Through partnerships with schools, healthcare providers, and community organizations, the Coalition has increased vaccination rates and educated the public about the benefits of the HPV vaccine. These efforts are critical in moving closer to the goal of eliminating HPV-related cancers. If you knew that you could avoid getting a fatal or potentially disfiguring cancer, would you get vaccinated?
With growing scientific knowledge and understanding of precision medicine and gene mutations, more and more family members of people diagnosed with cancer are getting genetic counselling, and sometimes even undergoing proactive interventions to avoid getting hereditary cancers. This is the case for carriers of the BRCA gene mutation, who sometimes chose to proactively and prophylactically remove their breasts or ovaries to reduce their chances of developing those cancers (it also exists in pancreatic and prostate cancer, but more frequent screening and testing is recommended in these cases. Diane Rose, my fellow NRG Patient Advocacy Committee member, wrote an excellent piece on her own lived experience being a previvor.
For cervical cancer, regular Pap tests can detect precancerous lesions and remove them before they develop into cancer. However, the Pap test, a test that was developed 100 years ago, is only 60% effective and can miss many cancers. In Quebec, we have successfully lobbied the government on behalf of the population to make the switch to HPV testing, which is much more accurate, has a higher sensitivity and earlier detection, as well as having a longer interval between tests.
Colorectal cancer screening, including a FIT (fecal immunochemical test) and a colonoscopy can also catch pre-cancerous polyps in the colon or rectum before they develop. People below the age of 45 or 50, depending on the jurisdiction, might not fall into the official screening programs, but can still request a FIT test and colonoscopy if they feel they might be at risk.
Taking Action: What You Can Do
Patient Advocacy groups have been leading the charge in cancer prevention in Canada, the USA and in Europe, but everyone has a role to play. Researchers provide us with the evidence of which risk factors are causal or correlational to developing cancers, and how to best intervene. Seeing so many people and their families suffering from preventable cancers is what motivates me personally to advocate for cancer prevention. So what can you do? Here are some specific recommendations for advocacy in cancer prevention:
1. Join Awareness Campaigns: Participate in and support campaigns that raise awareness about cancer prevention, such as skin cancer prevention initiatives.
2. Attend Conferences and Workshops: Engage with events that focus on environmental factors and lifestyle choices that impact cancer risk.
3. Promote HPV Vaccination: Advocate for the HPV vaccine within your community and encourage vaccination among eligible populations.
4. Promote participation in Screening Programs and Early Detection: If you have symptoms or risk factors for cancers with screening programs (lung, colorectal, prostate, breast, cervical cancer), look into it for yourself and promote it in your family and community.
5. Know Your Own Risk Factors: Identify your own risk factors and mitigate them proactively, whether they be related to alcohol or tobacco use, exercise, genetic risks or exposure to known carcinogens.
6. Adopt Healthy Habits: Incorporate regular exercise, a balanced diet, and sufficient sleep into your lifestyle.
7. Get Involved with Local Organizations: Support or volunteer with organizations like the Quebec Cancer Coalition that are dedicated to cancer prevention efforts.
Conclusion
Cancer prevention is a collective effort that requires raising awareness in our communities and among decision makers, as well as the commitment and collaboration of individuals, communities, and organizations. By taking proactive steps and supporting your own local initiatives and those of the Patient Advocacy Groups of your community, as well as listening to and working with people with lived experience, we can make a significant impact in reducing cancer rates and ensuring a healthier future for all.
Let's embrace this February, Cancer Prevention Month, as an opportunity to take action and promote a cancer-free future.