Explore the intricate dynamics of cancer prevention, as expounded by Prof Michael Herbst during the recent Medical Academic and Activo Health webinar.

On 29 February Medical Academic and Activo Health were proud to host a webinar entitled ‘Cancer prevention in SA: Upping our game.’ The webinar was presented by CANSA’s Prof Michael Herbst.

Prof Herbst began by clarifying that cancer cannot in fact be prevented, but that the risk of cancer can be reduced significantly. “Cancer is the second most prolific cause of death in the world,” Prof Herbst said.

“This might come as a surprise to some people, but when one conflates all the available mortality stats and one treats the various forms of cancer as one disease, the true scale of the condition becomes apparent.”

The most important characteristic of cancer is that an abnormal and uncharacteristic multiplication of cells occurs. This runaway multiplication results in the formation of a tumour. Cancer also causes inflammatory and septic responses in the tissue surrounding affected areas. According to the National Cancer Registry’s 2019 statistics, there were 7903 deaths from cancer in 2019.

CANCER CANNOT BE PREVENTED

“The stats revealed that over 500 children aged 0 to 9 years died of cancer-related causes in 2019, as confirmed by pathology reports,” Prof Herbst pointed out. “It should be clear that cancer asks no questions, does not care what population group one belongs to or what language one speaks. As recent reports have made clear, even a king can get cancer.” According to Prof Herbst, the confusion surrounding whether cancer can be prevented or not started with the interdisciplinary ‘borrowing’ of concepts surrounding the prevention of disease from the discipline of infectious diseases. “People talk about primary prevention, or intervening before health effects occur; secondary intervention, or patient screening to identify diseases in the earliest stages; and tertiary prevention, which is implemented in symptomatic patients and aims to reduce the severity of the disease as well as any associated sequelae.”

“If one examines the guidelines on cancer prevention published by the Union for International Cancer Control,” Prof Herbst stated, “then it becomes clear that what they are talking about is more aligned with cancer control than any sort of prevention effort.” Cancer control initiatives must take the form of risk reduction.

REDUCING RISK

Cancer risk can be reduced by several practical measures, including the avoidance of alcohol. “Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen in the 1980s by the International Agency for Research on Cancer (IARC),” Prof Hersbt emphasised. “Group 1 is the highest risk group, which also includes asbestos, radiation and tobacco products.”

Prof also indicated that smoking was a significant risk factor, as was the sedentary lifestyle people tend to lead. Perhaps the most unpopular measure in a braai-loving culture like South Africa is the avoidance of red meat. “IARC has classified consumption of red meat as a Group 2A risk factor, or ‘probably carcinogenic to humans.’ In making this evaluation, IARC took into consideration all the relevant data, including the substantial epidemiological data showing a positive association between consumption of red meat and colorectal cancer and the strong mechanistic evidence. Consumption of red meat was also positively associated with pancreatic and prostate cancer,” Prof Herbst said.

VAPING

Regarding the relatively recent vaping craze, Prof Herbst did not mince words: “It took decades for IARC to classify tobacco products as a Group 1 risk factor, and we may just be seeing the same delayed response with vaping products. We do not have a clue what the effects, in isolation or combined, of the chemicals in vaping products will be 10 or 15 years down
the line.”

What’s so great about Fotofinder mole analysis? Is biltong a processed meat? What is radon gas, why is it the second leading cause of lung cancer, and why is there so much of it in Paarl?

For the answers to these and other questions, watch a recording of this webinar at https://vimeo.com/event/4040442 to claim 1 CPD point.