Many cancers are preventable. Cancer could be identified by screening. Cancer research often focuses on heroic efforts of treating tumors at the late clinical stages. Dr. Anton Titov, MD. There is certainly a lot of money in that. But at the same time cancer is often described as "disease of civilization”. Because environmental pollution, the Western diet, the sedentary lifestyles are probably responsible for a significant number of cancer cases. Perhaps our lifestyle affects the majority of cancer diagnoses. Yes, absolutely, correct! Dr. Anton Titov, MD. What can a patient do to prevent cancer to the maximum extent possible? What can be done to diagnose cancer early? Dr. Bruce Chabner, MD. Correct! I think you're very correct that lifestyle is a very important factor in causing cancer. So smoking is responsible for a large group of cancers. It's not the majority, but it's a significant number of cancers. Lung cancers and bladder cancer, esophageal cancer, tumors of the head and neck. Many of those cancers are caused by smoking. So that is one major way in this patients can prevent cancer themselves. Dr. Bruce Chabner, MD. The other thing is diet. Obesity is associated with a number of different cancers. Obesity increases the risk of breast cancer. It increases the risk of certain cancers of the gastrointestinal system. So that is also a very important consideration. You need to moderate intake of calories. You have to lower content of red meats and fat. Pay attention to the way food is prepared. So not barbecuing, or using high temperature cooking that creates chemicals that cause cancer. So those are all very important things. The other thing is this. Dr. Bruce Chabner, MD. Many of the cancers that we deal with are caused by viruses. For example, the most common cancer in the developing world for women is cervical cancer. This is caused by the human papilloma virus [HPV]. So actually attention to papilloma virus vaccination and prevention methods for a papilloma [HPV] infection are very important. So there are a variety of things. You are correct in the sense that the majority of cancers are probably preventable. We can at least reduce their incidence by attention to these issues of lifestyle. One other thing that you alluded to in lifestyle. It is the sedentary lifestyle. We are watching TV, and sitting on a couch. It is clear now that exercise and fitness are important. They don't prevent cancer totally. But they certainly are important. Dr. Anton Titov, MD. There is a book by Vilhjalmur Stefansson "Cancer: the disease of civilization”. He wrote in the 1960s. It is amazing how despite all the knowledge we do not do much. Knowledge of cancer prevention does not necessarily translate into action. Doing is much harder than understanding. Dr. Bruce Chabner, MD. It sure is! It is, and so that's very important obstacle to cancer prevention. One of the other things that you mentioned, though, is very important. That is cancer screening. We know that that screening detects cancers earlier. It can actually detect pre-cancer changes before they become cancer. For example, polyps in the colon. So that is just the standard things. It is regular physical examination. It is important to do mammography and colonoscopy. We can prevent and detect early colon lesions. We can remove them before they become dangerous cancer. Dr. Bruce Chabner, MD. Now we have even chest CT scans. They are sort of the low-dose radiation lung CT scans. We use CT scans to detect lung cancers in smokers. So patients that have a strong smoking history should get chest CT scans. Cervical cancer is another lesion. If it's detected early, it can be cured. It's very important. Dr. Anton Titov, MD. Colorectal cancer is essentially a preventable cancer. There are 1,5 million cases per year of colorectal cancer around the world. You can prevent colon cancer by just doing a colonoscopy, or virtual colonoscopy, once every 10 years. You're correct. If we did this religiously. In other words we have to say this. Dr. Bruce Chabner, MD. We have to educate the patients and the general population. These things have to be a part of their thinking about cancer. It's not simply being afraid of cancer actually developing. They have to do things to prevent cancer. They have to take steps to detect cancer early. So that cancer is curable. Yes. Absolutely!