Debunking Cancer Myths

As we observe World Cancer Day this month, it’s a timely reminder of the ongoing fight against cancer, a leading cause of illness and death worldwide. In Singapore, cancer was the top cause of death from 2017 to 2021, accounting for 28.2% of all fatalities (1).

Despite advancements in medical science, several myths persist, potentially delaying diagnosis and treatment. Dispelling these misconceptions is crucial for effective cancer prevention and management. Let’s take a closer look at some common cancer myths and the facts behind them.

Common Cancer Myths and Facts

1. Myth: Cancer is a Death Sentence
   Fact: While cancer is a serious disease, it is not invariably fatal. Advancements in early detection, treatment, and supportive care have significantly improved survival rates. For instance, Five-year survival for distant stage prostate cancer improved from 28.7% during 2001–2005 to 32.3% during 2011–2016 (2).
2. Myth: Only Individuals with a Family History are at Risk
   Fact: Yes, a family history of cancer can increase your risk of developing cancer, but many people who develop cancer don’t have a family history (3).
3. Myth: Cancer is Contagious
   Fact: Cancer cannot be transmitted from person to person. However, certain viruses, such as human papillomavirus (HPV) and hepatitis B and C, can increase cancer risk and are transmissible (4).
4. Myth: Superfoods Can Prevent Cancer
   Fact: No specific food can guarantee cancer prevention. A balanced diet rich in fruits, vegetables, and whole grains, combined with a healthy lifestyle, can reduce risk but not eliminate it (5).

Regular health check-ups are vital for early cancer detection, significantly improving treatment outcomes. Adhering to national screening guidelines is essential. For instance, women aged 50–69 are advised to undergo mammograms every two years to screen for breast cancer (6).

Similarly, individuals aged 50 and above should consider annual Faecal Immunochemical Tests (FIT) for colorectal cancer screening (7).

By proactively participating in recommended screening programmes and maintaining a healthy lifestyle, you can enhance your chances of early detection and successful treatment.

References

1. Health365.sg. (2024). Cancer In Singapore – Health365. [online] Available at: https://www.health365.sg/cancer/ [Accessed 10 Jan. 2025].
2. Siegel, D.A. (2020). Prostate Cancer Incidence and Survival, by Stage and Race/Ethnicity — United States, 2001–2017. MMWR. Morbidity and Mortality Weekly Report, [online] 69. doi: https://doi.org/10.15585/mmwr.mm6941a1
3. Cancer Research UK (2018). Family history and inherited cancer genes. [online] Cancer Research UK. Available at: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/inherited-cancer-genes-and-increased-cancer-risk/family-history-and-inherited-cancer-genes
4. Schiller, J.T. and Lowy, D.R. (2013). Virus Infection and Human Cancer: An Overview. Viruses and Human Cancer, pp.1–10. doi: https://doi.org/10.1007/978-3-642-38965-8_1
5. Holmes, S. (2006). Nutrition and the prevention of cancer. The journal of family health care, [online] 16(2), pp.43–6. Available at: https://pubmed.ncbi.nlm.nih.gov/16715752/
6. Qaseem, A., Lin, J.S., Mustafa, R.A., Horwitch, C.A., Wilt, T.J. and Clinical Guidelines Committee of the American College of Physicians*, 2019. Screening for breast cancer in average-risk women: a guidance statement from the American College of Physicians. Annals of internal medicine, 170(8), pp.547-560. doi: https://doi.org/10.7326/m18-2147
7. Recommendations on screening for colorectal cancer in primary care. (2016). Canadian Medical Association Journal, 188(5), pp.340–348. doi: https://doi.org/10.1503/cmaj.151125

The Importance of Pre-Exercise and Pre-Marathon Cardiac Screening

As cardiologists, we encourage regular moderate exercise to reduce your long term risk of heart disease.

An athlete’s sudden cardiac death is one of the tragic risks of strenuous exercise in the presence of a dormant cardiac abnormality.

Most major international sports organisations recommend a pre-exercise cardiac screening for the participants. The aim of screening is to identify these “silent” but high-risk problems that increase the risk of death due to high-intensity exercise.

In younger athletes – under 35 years – the usual causes of sudden cardiac death are due to structural abnormalities affecting the heart. These abnormalities can be genetic or acquired. They can affect the heart muscle, valves or anomalous origin of the coronary arteries. Another major subset of conditions that run a higher risk are electrical cardiac abnormalities. Cardiologists believe that the mechanism of sudden death is secondary to a malignant arrhythmia.

In older people, the most common cause of sudden cardiac death is due to coronary artery plaque rupture leading to a heart attack. High blood pressure, smoking, high LDL cholesterol, diabetes and a family history of premature coronary disease increase this risk.

The vast majority of individuals who suffered a fatal cardiac event showed no prior symptoms. Worrying clinical features include:

• Chest pains, giddiness, dizzy spells, palpitations or blackouts during exercise
• Feeling short of breath which is out of proportion to the intensity of the exercise
• Family history of a hereditary cardiac disorder or sudden cardiac death

The pre-exercise cardiac screening includes a medical history, physical examination, an ECG and echocardiogram. All the tests are safe, non-invasive, can be done at a clinic and take no longer than 1 hour to perform. Currently, genetic testing for common genetic cardiac conditions is not part of a cardiac screening.

Another pre-exercise screening test is cardiopulmonary exercise testing (CPET). This is a non-invasive simultaneous measurement of the cardiovascular and respiratory systems during exercise to assess an individual’s capacity. A CPET has many applications for evaluating a wide range of cardiac problems. The peak VO2 max achieved is a measure of someone’s maximal physiological uptake of oxygen. This means that it can act as a surrogate marker of cardiovascular fitness. The peak VO2 max can guide exercise training programs.

Pre-exercise screening has the potential to identify a high-risk subgroup of individuals. Based on the results, doctors can then tell them about their best exercise options. In the case of a high-risk patient, the screening will also provide an opportunity to prevent sudden cardiac death by implantation of an automated cardio-defibrillator.

Contributed by:
The Harley Street Heart & Vascular Centre
https://www.harleystreet.sg/heart/
WhatsApp +65 8031 2388