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Age and heredity/ All the reasons why people get cancer

2023-09-09 15:11:00, Shëndeti Vera Martinella

There is no definitive answer as to why a tumor develops in a person's body, but many risk factors are known that play a more or less decisive role: age, heredity, lifestyle and environmental factors. Great progress has been made in this field and it is now clear that the uncontrolled proliferation of cancer cells depends on gene changes (mutations).

"Some of these mutations are inherited, but most of them are caused by external factors, driven by our behavior or by the environment we live in," says Saverio Çinieri, president of the Italian Association of Medical Oncology (AIOM).

Age

Aging is the most important risk factor for cancer. Most cancers develop in people over the age of 60. So in many cases, tumors are considered "typical pathology of aging". This is also the main reason why tumors are increasing all over the world, in parallel with the extension of life expectancy and the increase in the number of elderly people.

In the elderly, the risk of developing cancer is about 40 times higher than in people aged 20-40, and 4 times higher than in those aged 45-65. Between the ages of 50 and 69, 1 in 5 men and 1 in 7 women are likely to have a cancer diagnosis.

Heredity or familiarity

Are tumors hereditary? This is a frequently asked question. It is a very widespread fear. "But if you see the data, you will calm down: only a small minority of all cancers diagnosed each year are categorized by doctors as inherited in the family," says Çinieri.

And this does not mean that the disease is transmitted through genes, but only that there is a greater predisposition to develop that disease. Therefore, if there have been several cases of cancer in the family, this does not mean that sooner or later all members will get sick, but only that more attention should be paid to following a healthy lifestyle and controlling regularly to the doctor.

In fact, it is possible to inherit a gene that has mutated and makes the cell more susceptible to disease. But for the tumor to start developing and growing, other changes must be added, the expert emphasizes. For this reason, doctors advise that people do not undergo paid genetic tests, without having a specific medical indication, which can highlight a greater statistical probability of being affected by cancer.

Ways of life

Experts from all over the world have been repeating it for some time: more than 1 in 3 cases of cancer can be avoided just by adopting healthy lifestyle habits. The advice is simple: don't smoke, don't drink alcohol, follow a moderate food diet, exercise regularly, prevent infections that can cause cancer.

In addition to tobacco, which is responsible for a long list of cancers (from lungs to mouth), the choice of what we put on our plate seems to be increasingly important (those who eat well avoid half of cancers). And verified evidence from several studies shows that overweight and obesity are among the known risk factors for endometrial, colorectal, esophageal, kidney, pancreatic, and breast cancer, especially in postmenopausal women.

It has also been scientifically proven that moderate physical activity (such as brisk walking) for at least half an hour 5 days a week helps keep away various forms of cancer. Finally, it is essential to carefully expose yourself to the sun, avoiding burns that can favor the appearance of skin cancer (it is no coincidence that artificial tanning lamps are included in the list of known carcinogens).

Environmental factors

Only about 5 percent of cancer cases are caused by the environment in which we live, and may originate from environmental pollution. In the surrounding environment there are several elements that can favor the appearance of neoplasms. Some are present in nature, such as ionizing radiation (from cosmic rays penetrating the atmosphere); asbestos, responsible for the dreaded pleural mesothelioma, and several metals, including arsenic, beryllium, cadmium, chromium, lead, and nickel.

Others are chemical products to which certain categories of workers may be more exposed. For example, benzene, which is found in some solvents and dry cleaning materials, but also in cigarette smoke, and which increases the risk of leukemia. Dioxins are substances that are produced during various manufacturing processes. They tend to accumulate in the environment and foods. Other dangerous substances are found in some pesticides used in agriculture and vinyl chloride, with which those who work in the plastic industry come into contact.

Or the polycyclic aromatic hydrocarbons present in car exhaust gases and in the smoke produced by burning wood in stoves, which can favor the development of lung, skin and urinary tract tumors.

Viruses

In Italy, as in other high-income countries, chronic infections are the cause of about 7-8 percent of all malignant tumors diagnosed each year. So less than 30,000 cases per year out of 377,000 in total, says the expert.

They are caused by several chronic infections (including hepatitis B and C viruses, Epstein-Barr, HIV, and human papillomavirus, or HPV), which can be avoided or even largely prevented by vaccination. Staying for many years in various organs and tissues, these infectious agents can cause the formation of various tumors based on the individual characteristics and those of the infectious agent.

Hepatitis B and C viruses can lead to liver tumors (hepatocarcinoma). HPV causes tumors of the cervix and oral cavity, vagina, vulva, anus. Meanwhile, Helicobacter pylori promotes stomach tumors. Also, some blood cancers, lymphoma and leukemia are linked to varying degrees to Epstein-Barr virus infection.

Epigenetics

"That cancer is caused by errors in the DNA sequence, whether they are inherited, accidental or due to external agents such as cigarette smoke, this is already well known," Çinieri explains. However, in addition to genes, there are several other changes that, although they do not modify the DNA sequence itself, have an impact on the normal expression of genes, activating some and repressing others.

This causes in some cases the uncontrolled growth of cells typical of tumors. Therefore, we can no longer talk only about the genetics of tumors, but we should better study epigenetics (from the Greek "on genes"), that is, all those transformations that "turn on" and "turn off" different genes./ Adapted from CNA