Cancer Prevention

Prophylaxis of cancer is based on modern knowledge of the mechanisms of carcinogenesis. The experience of experimental and epidemiological studies indicates the existence of a direct connection between the effect of external agents, endogenous metabolites and the development of tumors with a certain latent period under their influence. Prevention of malignant neoplasms is a complex of measures for their primary and secondary prevention.

[1], [2], [3],

Primary prevention of cancer

Such cancer prevention is aimed at eliminating or weakening the effect of carcinogenic factors (chemical, physical and biological) on the human body, reducing their effect on the cell, increasing the specific and nonspecific resistance of the organism. Primary cancer prevention is carried out with the help of sanitary and hygienic measures, as well as by correcting biochemical, genetic, immunobiological and age-related disorders in humans, which allows to reduce the incidence of cancer by more than 70%.

Individual protection of an organism from malignant tumors should include the following measures:

• compliance with personal hygiene;
• therapeutic correction of impaired body functions;
• correct rational nutrition;
• rejection of bad habits;
• optimization of the functions of the reproductive system;
• maintaining a healthy active lifestyle;
• formation of a person's high self-awareness.

Oncohygienic cancer prevention also consists in eliminating carcinogenic impurities from the inhaled air and water.

Air Hygiene

Priority is the fight against smoking. A complete cessation of smoking is an optimal means of individual prevention of lung cancer.

Under the auspices of WHO, a Partnership Program for the European countries has been developed, aimed at combining efforts to combat smoking and delivering smokers from tobacco dependence.

Along with giving up smoking, the responsible task is to fight for the purity of atmospheric air, which is of special importance for workers with occupational hazards, as well as for residents of industrial cities with polluted industrial emissions.

Preventive measures include the placement of industrial enterprises outside the city limits, the expansion of zones of green spaces, the creation of closed production cycles, non-waste technologies, the establishment of catching filters at enterprises.

In residential premises, good ventilation of kitchens and living rooms is necessary, especially in houses with high content of asbestos fibers, metal impurities and an increased radioactive background.

[4], [5], [6], [7], [8], [9],

Physical activity

A person who is in a sedentary or inactive position for more than 5 hours a day has a high risk of stagnation in all parts of the body and internal organs. This negatively affects the function of lymphocytes, which leads to hypoxia, hypoventilation and impairment of drainage function of the lungs. When comparing groups of people with high and low physical activity, it was found that the incidence of malignant tumors is 60% lower in the first group. The value of physical training is obvious when they are held regularly.

Food Hygiene

Among the factors contributing to the emergence of malignant neoplasms, the alimentary factor is 35%. An important measure of individual cancer prevention is abstinence from excessive nutrition and a reduction in the amount of fat in the diet. Reducing fat intake to 20 - 25% leads to a decrease in cholesterol and estrogen levels and, consequently, incidence of cancer of the colon, breast, uterine body, pancreas and other organs. Men are recommended to limit 75 grams, and women - 50 grams of fat per day.

Prevention of cancer is also limited to fried foods, pickles, marinades, smoked products. It should be avoided long-term use of superheated fats, frying open gas burners on the flame or charring products. This will reduce the content of carcinogens formed in the process of cooking food.

However, one food with a low fat content does not solve the problem of cancer. To reduce the risk of the disease, the food ration should be diverse, it must include a sufficient number of vegetables and fruits rich in vitamins, minerals, fiber and a variety of unique biochemicals. They prevent the formation of carcinogens, slow their activation and inhibit carcinogenesis after exposure to a carcinogenic agent.

All fruits and vegetables are useful, but of particular value are the families of umbrellas (carrots, parsley), cruciferous (cabbage, asparagus and other types of cabbage) vegetables, vegetable oils, soybeans.

Great importance is attached to vitamins A, C and group B. Vitamin A and carotenoids prevent the accumulation of carcinogens in the body and reduce their effect on cells. They prevent the development of cancer of the esophagus, stomach, lung, bladder, prostate and colon. Beta-carotene is effective in preventing spontaneous, chemical and radiation carcinogenesis, preventing the development of skin tumors induced by UV irradiation. Vitamin C in high doses (up to 10 g) has antioxidant properties, inhibits the formation of nitrosamines from nitrites, stimulates immunity, reduces the risk of cancer of the esophagus, stomach.

Prevention of colon cancer is the use of foods rich in coarse fiber and B vitamins. Poorly digested plant tissue leads to dilution of carcinogens in a large number of feces, accelerates the evacuation of contents from the intestine, changes the metabolism of bile acids, reduces the pH of the environment.

The necessary components for the prevention of malignant tumors are macro- and microelements. An important role belongs to selenium and calcium, the lack of which leads to an increase in the incidence of cancer and the intensification of metastasis processes.

The European Cancer Program contains a list of nutrition recommendations.

1. The probability of developing cancer in different individuals is largely determined genetically, but the current level of knowledge does not allow identifying people at high risk. Recommendations should be applicable to people over two years old.
2. There are specific recommendations for nutrition:
   • the intake of calories from fat burning should not exceed 30% of the total energy value of food. Including less than 10% should provide saturated fats, 6 - 8% - polyunsaturated fats, 2 - 4% - monounsaturated;
   • it is necessary to consume a variety of fresh fruits and vegetables several times a day;
   • it is necessary to balance the physical load and diet to maintain normal body weight;
   • should limit the intake of salt, food, preserved with nitrites, nitrates and salt. The salt intake should not exceed 6 g per day;
   • limit the consumption of alcoholic beverages.

[10], [11], [12]

Secondary cancer prevention

Secondary cancer prevention is a complex of medical measures aimed at identifying patients with precancerous diseases with their subsequent recovery and monitoring them. The effectiveness of such prevention is unquestionable, although it is far from being the same for different localizations. Due to the detection of precancerous diseases at the level of the examination rooms and their subsequent treatment, there has been a tendency to reduce morbidity, for example, cervical cancer. The organization and conduct of activities for early detection of cancer is also considered as secondary prevention of cancer.

Preventive oncological examinations are subjected to persons over 30 years of age. In this case, special attention should be paid to the elderly. Examinations are carried out by medical workers of the general medical network. Methodological guidance is carried out by oncologists.

Preventive examinations should include mandatory external examination, which includes examination and palpation of the skin, visible mucous membranes, peripheral lymph nodes, thyroid and mammary glands, cervix, men - testicles, finger examination of the rectum. The tumor damage of the organs of the listed localizations is more than 50% in the structure of oncological diseases.

There are mass and individual examinations. Mass examinations mean the examination of large contingents of people working in enterprises, institutions, collective farms and state farms, conducted according to a pre-planned plan.

Individuals call examinations in order to detect cancer in people who have contacted a polyclinic or are on treatment in a hospital. In addition to patients who have come to an outpatient reception, people who work in the food industry, trade and children's pre-school establishments, as well as the disabled of the Patriotic War, are subjected to an individual examination. It is compulsory when applying for a job and referring to a sanatorium treatment.

Mass preventive examinations, depending on the objectives and scope of surveys, are divided into complex and targeted.

Comprehensive examinations of a healthy population by a group of doctors of different specialties, conducted to identify various diseases, including malignant tumors. Such inspections are usually carried out at industrial enterprises, especially in harmful industries: the nickel industry, uranium mines, aniline dye production facilities, etc. In agriculture, machine inspectors and milkmaids are subjected to a comprehensive survey.

Trustees consider examinations conducted to detect one or a group of homogeneous diseases. The task of these examinations is early detection of malignant neoplasms and premalignant diseases. Targeted examinations are performed by doctors or nurses.

Targeted inspections by medium-sized medical personnel are called two-level examinations. They are used mainly in rural areas. At the same time, a paramedic or midwife examines the entire healthy population, and the doctor is sent to a doctor with a suspicion of a malignant tumor or a precancerous disease to clarify the diagnosis.

Massive preventive inspections must meet four basic requirements.

1. The survey methods used must have a sufficiently high resolution.
2. They should be technically simple and not require significant economic costs.
3. The frequency of examinations of different categories of the population should be determined by the probability of the occurrence of malignant neoplasm.
4. There should be a clear continuity between the stages of screening and subsequent in-depth follow-up and treatment of patients.

The bulk of a healthy population is usually subjected to a preventive examination every year. Persons belonging to high-risk groups, as well as people working in harmful industries, are examined more often, usually once every 6 months.

In recent years, an intensive search for new forms of conducting preventive examinations. A wide network of fluorography and examination rooms was created. Preventive departments are deployed at city polyclinics. In practice, a questionnaire method of collecting information about harmful factors and the state of human health is introduced. The analysis of the obtained data is carried out with the help of special diagnostic tables or computer equipment. Persons who have identified risk factors are subjected to in-depth examination.

Early diagnosis of malignant tumors, which is currently the main condition for their successful treatment, should be carried out not through the patient's referral for help to a doctor, but through appropriate screening programs, follow-up and in-depth systematic examinations of individuals at increased risk for malignant neoplasm .

It should be noted that molecular biological studies can already be used as diagnostic tests in groups at increased risk of developing cancer. According to A.G. Tatosyan (2001), relatively inexpensive screening, non-invasive research programs based on detection of altered fragments and combinations of oncogenes, for example, in sputum, can be developed on the basis of molecular biological methods. Persons who have a molecular precancer should avoid contact with carcinogens and systematically undergo in-depth medical examinations.

Tertiary cancer prevention

Prevention of cancer recurrence is considered as a tertiary cancer prevention.

The effectiveness of prevention depends on the level of anticancer advocacy, which begins long before medical examinations and continues in their process using all channels and forms of mass and individual information.

Anti-cancer propaganda among the population sets the following goals:

• acquaint the population with the first signs of cancer;
• persuasion of the need for regular medical examinations;
• upbringing of a habit to consciously monitor the state of one's health, training in methods of self-examination (oral cavity, mammary glands, etc.);
• instill confidence in the success of cure with timely detection of cancer;
• promotion of healthy lifestyles, sanitary and hygienic knowledge - the basis of an event such as primary cancer prevention.