We can all lower our cancer risk

Exercise and healthy diet are keys to a longer life

By BILL EVANS

There is a city park near my home in Hamilton’s Durand neighbourhood. Climbing equipment invites young children and their parents. There is space to run, space to kick around a ball.

It’s a vibrant place on any warm, sunny day.

Where does cancer fit into this picturesque scene? Parks such as this could be one part of the answer to lowering the cancer numbers in a city such as Hamilton.

In an industrial city renowned for its smoke stacks, it may seem ridiculous and simplistic to think self-regulated lifestyle factors such as exercise are answers to lowering cancer risk when there are obvious “out-of-my-control” factors such as air pollution.

But think again. The simple truth is Hamilton and the region surrounding it have higher rates of obesity, smoking and alcohol use than the provincial average. Those numbers show up again in the just released Cancer System Quality Index as they have for a number of years.

There is a link between these modifiable risk factors and cancer. Cancer Care Ontario reports more than half of all cancers are preventable and about half of cancer deaths are related to tobacco use, diet and physical activity.

How does that show up here? The Local Integrated Health Network representing this area (Hamilton-Niagara-Haldimand-Brant) has higher than provincial rates of prostate and lung cancers.

The message is eat more fruits and vegetables, exercise more, avoid smoking and excess alcohol and stay fit to reduce cancer risk. Pretty basic ideas, and the good news is we fare a bit better than the provincial average on exercise and fruit and vegetable consumption.

Of course, saying we should use parks more is a terrifically simplistic answer to a huge problem. But we have to start taking action on what we personally can do to reduce our risk of having cancer, rather than merely fretting about all of those things that are out of our control.

Why we aren’t taking control is a complicated matter. A 2008 study by Cancer Care Ontario and Environics showed people are very worried about cancer, more so than heart disease and diabetes.

But when it comes to what they think will help to prevent cancer, things go a little awry. Many feel exercise will improve health, yet many fewer say it will help prevent cancer. It’s a very similar picture with eating healthier food. In fact, the study found when people were asked what factors contributed to growing cancer numbers, about half picked pollution and chemicals in the environment, while only a quarter picked unhealthy lifestyles, diet and lack of exercise.

There is no doubt pollution, toxins, and chemicals can cause some cancers. But we also have to take personal responsibility for what we do to our own bodies.

An estimated 173,800 new cases of cancer and 76,200 deaths from cancer will occur in Canada this year, according to the Canadian Cancer Society. A 2008 report said 40 per cent more people will be living with cancer within the next decade.

We can blame much of the increase on an aging population — about 40 per cent of new cancer cases and 60 per cent of cancer deaths occur among those 70 years of age and older, according to the Canadian Cancer Statistics.

As our bodies deal with the cumulative effects of whatever bad things we’ve breathed, eaten and touched, our chance of getting cancer increases.

And our region has a higher percentage of older individuals than the provincial average. On the good news end, overall cancer mortality rates have been declining.

All areas could improve, but generally we’re doing an increasingly good job of lengthening people’s lives after diagnosis. We’re still struggling with reducing our risk.

One reason lies in the problems flagged so well in The Spectator’s Code Red series, where socio- economic conditions and health were so clearly linked. It connected areas of Hamilton with poor socio-economic conditions and lower education level to higher hospital admission rates and emergency room visits.

Cancer Care Ontario points out “individuals with a lower level of education are more likely to be obese, and to smoke, and that as an individual’s education level increases, the likelihood that she/he will be obese or smoke declines.”

Now throw in what low income does to ability to buy healthy foods. A 2005 Insight on Cancer connected low income to inability to buy foods required for good health. Remember, fruits and vegetables are linked to reduced cancer risk.

Bottom line: If you don’t have wealth, it’s hard to buy health.

We need to focus on building jobs in Hamilton. People need steady, decent paying jobs. Ideally, employers would then take some responsibility for the health of their workforce — nutrition and cooking classes, exercise bikes or rowing machines in the building, and encouragement to use them.

Maybe we need tax relief for employers who take these kinds of measures, and tax relief for those living this healthier life; and maybe a tax burden on merchants of unhealthy food.

Education needs to be promoted as a means to a brighter future.

And maybe the city should step up by ensuring children have access to nutrition programs in schools, and parks within walking distance of their homes that are safe and have the space to run, kick a soccer ball, and land a basket.

I go back to my local park, and its small role in changing lives, and I see the possibility.

The messages aren’t complicated. Living them is.

Dr. Bill Evans is president of the Juravinski Cancer Centre and regional vice-president of Cancer Care Ontario. He is a medical oncologist, who has worked in Toronto at Cancer Care Ontario and the Ottawa Regional Cancer Centre. He has lived in Hamilton for five years.

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