Cancer, the word itself was once the equivalent of a death sentence, and even with medical advances, the disease still means a long, hard battle ahead.

Cancer was once thought to be the result of mutant genes - simply bad luck. Today, however, physicians and scientists recognize that lifestyle factors play a significant role when it comes to cancer risk.

"Genetics accounts for only 15 percent in the cancer field - not as large a role in cancer risk as once thought," says Professor Yang Binghui, a noted cancer expert and honorary president of the Shanghai Zhongshan Hospital. "Instead, the main threat comes from unhealthy lifestyles."

Globally, cancer causes 6 million deaths every year and is responsible for 12 percent of deaths worldwide. According to the World Health Organization, more than 10 million people annually are diagnosed with cancer. It is a disease on the upswing: Cancer rates could further increase by 50 percent to 15 million new cases by the year 2020.

Cancer is also an equally big problem locally. The Shanghai Cancer Institute reports that cancer has become the No. 1 killer for local people aged between 30 and 60, with about 20,000 new cases every year. Nearly 80 percent of cancers stem from harmful lifestyles, which are on the rise in Shanghai.

"The role of lifestyle in causing cancer means that the cancer spectrum of local people is getting more and more similar to those of Western people," adds Professor Yang. "Cancer is not inevitable. The key concept in Chinese medicine is health preservation, and one-third of cancer risks can be effectively reduced by sticking to a healthy lifestyle and an optimistic mental condition."

According to health experts, cancer is largely preventable, particularly by avoiding high-risk behaviors like smoking and exposure to carcinogens and adopting a healthy diet - all of which are within our own control.

Tobacco use is responsible for both lung cancer and cancers of the mouth, esophagus, bladder, kidney, pancreas, cervix and even leukemia.

Additionally, lung cancer is the leading cause of cancer death among men in Shanghai. With the highest incidence of lung cancer in China at about 75 cases per 100,000 people, Shanghai was dubbed China's "lung-cancer capital" last year by the International Lung Cancer Forum.

Yet despite the fact that cigarette packages in China must contain a small warning that smoking is bad for health, and many public venues are no-smoking zones, more than 60 percent of the city's male adult population still smokes.

For many smokers, for whom cancer seems like the vaguest of threats, smoking is a key part of socializing and business.

Indeed, Yu Wenjun admits that he has no idea how to socialize without cigarettes. "Yes, I know that smoking is bad for health," says the 30-year-old computer salesman. "But you know, it's a good way to start a conversation and turn strangers into friends, both in business and daily life. Without passing the smokes round, I don't know how to start chatting."

Worse still, the rate of adolescent smokers also appears to be increasing. It is estimated that about 12 percent of the city's youngsters are addicted to tobacco, although many cigarette counters have signs that young people under 18 years old are not allowed to buy cigarettes.

Xu Liang, a 19-year-old student at a local vocational school, began smoking a year ago.

"Don't you think it's a sign of maturity and charm," asks Xu, beaming. "Surely it's also a good way to distinguish myself from other classmates and help me earn more attention."

Passive smoking is another prominent issue nowadays. Scientific studies have shown that passive smoking can cause lung cancer and other diseases such as heart disease and respiratory disease among non-smokers. There is an estimated 16 percent increased risk of lung cancer among the non-smoking spouses of smokers, while the risk decreases after cessation of exposure.

"Women and children are the major victims of passive smoking," Professor Yang adds. "When one smokes, it's no longer a personal activity that only harms himself. Instead, he should take the health of others around him into account and think twice before picking up that cigarette."

In addition to abstaining from smoking, a healthy diet is another essential anti-cancer factor. With the spread of fast food, more and more local children are becoming addicted to their flavor and the toy presents. However, Professor Chen Dexing, a nutrition expert from Shanghai Traditional Chinese Medicine University can't conceal his worries about the constitution of the young generation.

"Even my child can't resist the attraction," Chen says. "It is so popular among the children. But I still can't imagine what kind of benefits fried chicken, greasy meat and several leaves of lettuce bring to them. Without a sufficient intake of vegetables and grain, these children's regular nutritional structure is likely to be destroyed."

Chen also points out that the recipes and eating habits of the Chinese people should not be blindly Westernized, as the food meets the needs of their Oriental physique.

"Some Chinese dishes have undergone centuries of testing and proved to be the most suitable ones for the Chinese people," adds Chen. "Why should we abandon this in favor of Western fast food that doesn't suit us well? It can lead to harmful results, particularly for children who are in need of balanced nutrition. Of course, Chinese diet is not perfect. People should keep away from some greasy and deep-fried dishes."

Chen's right. A recent survey indicates that the incidence of rectum cancer patients is becoming younger. Among all the local rectum cancer patients, 6 percent of them are under the age of 20, 5 percent more than a decade ago. As a typical malignant tumor of the alimentary canal, rectum cancer is posing a bigger threat to young people with irregular, often unhealthy diets.

Vivian Ji, a 20-something white-collar marketing employee, is a typical example.

"I always skip lunch," Ji says. "To carve out more time for work, I usually eat biscuits, instant noodles and fast food as a substitute. When a project is successfully completed, then I go with my friends and colleagues for a big feast."

"Sticking to this kind of diet can increase the risk of cancer," Chen says. "Although there is now plenty of pressure in the workplace, work should not have to come at the expense of health. And I'm seeing some young people who eat too much greasy food, like hot pot and water-boiled fish. An excess of food like this can make digestive systems vulnerable."

Experts suggest eating more coarse grain, vegetables and fruit, and limit the amount of high-fat, high-protein and fried food in their diets. A balanced intake of different foods can effectively reduce the risk of cancer in the long run.

"A healthy lifestyle includes many other factors, such as one's psychological state, exercise and sleep," Professor Yang concludes. "But all these are within our control. In other words, we really can prevent cancer by changing some relatively small, but ultimately risky, behaviors."   

Preventing Cancer
   
-- Stop smoking. All types of tobacco can put you on a collision course with cancer. Avoiding tobacco in any form significantly reduces your risk of cancers of the lung, esophagus, voice box (larynx), mouth, bladder, kidneys, pancreas and, in women, the cervix.

-- Choose most foods you eat from plant sources. Eat five or more servings of fruits and vegetables each day. Green and dark yellow vegetables, beans, soybean products and cruciferous vegetables - such as broccoli, brussels sprouts and cabbage - may help reduce your risk of colon and stomach cancers.

-- Limit fat. Eat lighter and leaner by choosing fewer high-fat foods, particularly those from animal sources. High-fat diets may increase the risk of cancers of the prostate, colon, rectum and uterus.

-- Drink alcohol in moderation, if at all. Even a moderate amount of drinking may increase your risk, particularly if you smoke. The impact of alcohol and tobacco on your risk level may be even greater when they're used together, significantly increasing your risk of cancers of the mouth, esophagus and larynx.

-- Protect yourself from the sun. Excessive sun exposure is by far the most common cause of skin cancer. It requires you to avoid peak radiation hours - usually between 10am and 3pm. Protect your skin with sunscreen and stop pursuing a sun-tanned skin.

-- Stay active and maintain a healthy weight. Obesity may be a risk for cancers of the prostate, colon, rectum, uterus, ovaries and breast. Physical activity is an important part of controlling your weight. Besides, keeping optimistic and happy is also important to prevent the intrusion of diseases.

-- Get enough sleep every night and try to improve its quality. A good night's sleep offers many benefits, in particular, the enhancement of your immune system. Never neglect the role of sleep in your life.

-- Do regular exercise. It's very important to people today, who are getting used to a sedentary life. Enough exercise will not only boost your immune system but also challenge your will and persistence.

(Shanghai Daily May 6, 2004)