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Lifestyle changes can cut risk of developing many types of cancer

The Tribune Interview: Dr Rakesh Kapoor, Professor at PGIMER
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On World Cancer Day, talking to Sheetal, Prof Rakesh Kapoor from Department of Radiotherapy and Oncology at PGIMER and president of Gastrointestinal Oncology Society of India discussed the significant advancements in cancer treatment, the evolving role of early detection, and how lifestyle choices can play a pivotal role in cancer prevention. With a focus on raising awareness and combating misconceptions, here’s expert advice on how we can approach cancer more effectively, both as individuals and as a society.

How has cancer treatment evolved over the years, and what are some of the most exciting advancements in oncology?

Cancer treatment has made incredible strides over the past several decades and the progress we’ve seen is nothing short of remarkable, starting from diagnosis up to the management in the radiation oncology, skills and techniques. Initially, treatment for cancer was largely limited to surgery, radiation and chemotherapy. However, with the advancements in medical research, we now have a broader array of treatment options tailored to individual patients and specific cancer types, such as targeted therapy, immunotherapy, precision medicine and CAR-T Cell Therapy.

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Also, we have got a lot of advancement in the sub-classification of cancer and that is with the amino and molecular marker so you can have better classification.

Which cancer has increased in patients over the past decade? What are other most common cancer patients?

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Breast cancer is on the rise in females whereas cervical cancer occurrence rate has gone down slightly. Ovarian and endometrial cancer has also increased in women. In males, lung cancer is the most common followed by the neck, gastrointestinal cancer and prostate cancer.

How do lifestyle factors such as diet, exercise and environment contributes to the risk of cancer?

Lifestyle factors, including diet, exercise and the environment, can have a profound impact on cancer risk. While not all cancers are preventable, there are clear connections between certain habits and behaviours that can either increase or decrease the risk of developing cancer. I hold ageing and eating habits the most accountable for cancer. Also, sedentary lifestyle is responsible as people no longer indulge in physical or outdoor activities. Hormone dependent cancer, such as breast cancer or prostate cancer, occur in the obese people.

How important is early detection and what methods have shown the most promise in diagnosing cancer early?

Early detection of cancer is crucial because it allows for the possibility of treating the disease before it spreads, which greatly improves the chances of a cure or successful management. There are few cancers where early detection is successful such as breast cancer, oral cancers, esophageal cancer or stomach cancer.

Screening tests such as Mammography (for breast cancer), Colonoscopy (for colorectal cancer), Pap Smear and HPV Test (for cervical cancer), Low-dose CT Scan (for lung cancer) are really helpful in early detection.

Can you talk about the role of genetic testing in early cancer detection and personalised treatment plans?

For individuals with a family history of certain cancers (like breast or colon cancer), genetic testing for inherited mutations (such as BRCA1 and BRCA2 for breast cancer or Lynch syndrome for colorectal cancer) can identify those at higher risk. This allows for more frequent or earlier screening, potentially detecting cancer before symptoms appear.

How do you manage the psychological and emotional impact of cancer diagnosis on patients and what support systems are essential in their care?

Cancer is not a disease for the patient, but is a disease of the family. Cancer affects more than just the body—it has a significant impact on a patient’s emotional and psychological well-being as well as his/her entire family. Managing the emotional and psychological impact is just as important as treating the physical aspects of the

disease.

I also believe end-of-life care (palliative and hospice care) often ignored is also an important part to improve quality of life of the dying patient. Lastly, spirituality also helps in overall morale of patient undergoing treatment.

How do you see the integration of Artificial Intelligence and machine learning in oncology research and treatment planning?

Oncologists are increasingly using AI and machine learning to analyse vast amounts of medical data, such as tumour imaging and genetic sequencing, to predict treatment responses and assist in clinical decision-making. AI is helpful in high-end radiations planning system, diagnostics radiology and pathology regression model. Also, it has proved beneficial in personalised treatment planning.

On World Cancer Day, what is one thing everyone should know about cancer that could help change the way we approach the disease, either in terms of prevention or support?

Prevention is just as important as early detection. Simple lifestyle choices—like maintaining a balanced diet, exercising regularly, avoiding tobacco and limiting alcohol—can drastically reduce the risk of developing many types of cancer.

It’s also crucial to understand the importance of vaccines, such as the HPV vaccine, which can prevent certain cancers caused by viral infections.

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