who approach life with an attitude that all of life is a gift will be
more likely to find the good in bad life circumstances. They are more
likely to move forward following a catastrophe. In fact, they may be
more likely to label such an event a gift."
It seems a common thread -- the fact that cancer makes us all stronger
in one way or another. It's one of the silver linings, I think. Cancer
can be a gift. We just have to regard it as one and look hard for its
WHAT CANCER CANNOT DO
Cancer is so
It cannot cripple love,
It cannot shatter hope,
It cannot corrode
It cannot destroy
It cannot kill
It cannot suppress
It cannot silence
It cannot invade the
It cannot steal
It cannot conquer the
P.A.V.E.L. HELPLINE for young
cancer patients: 0800 800 421
European Code Against
made to reduce cancer occurrence should not be one which could lead to
an increased risk of other diseases. The recommendations which comprise
the revised European Code Against Cancer should, if followed, also lead
to improvements in other aspects of general health. It is also
important to recognise from the outset that each individual has choices
to make about their lifestyle some of which could lead to a reduction
in their risk of developing cancer. These choices, and the rationale
underlying their recommendation, are presented below.
Certain cancers may be avoided and general
health improved if you adopt a healthier lifestyle:
- Do not smoke;
if you smoke, stop doing so. If you fail to stop, do not smoke in the
presence of non-smokers
- Avoid Obesity
- Undertake some
brisk, physical activity every day
- Increase your daily
intake and variety of vegetables and fruits: eat at least five
servings daily. Limit
your intake of foods containing fats from animal sources
- If you drink
alcohol, whether beer, wine or spirits, moderate your consumption
to two drinks per day if you are a man and one drink per day if you are
- Care must be taken
to avoid excessive sun exposure. It is specifically important to
protect children and adolescents.
- For individuals who have a tendency to burn in the sun
active protective measures must be taken throughout
strictly regulations aimed at preventing any
exposure to known cancercausing substances. Follow all health
and safety instructions on substances which may cause cancer. Follow
advice of national radiation protection
There are public health programmes that
could prevent cancers developing or increase the probability that a
cancer may be cured:
- Women from 25 years of
age should participate in cervical screening.This
should be within programmes with quality control procedures in
compliance with European Guidelines for Quality Assurance in Cervical
- Women from 50 years of
age should participate in breast screening. This
should be within programmes with quality control procedures in
compliance with European Union Guidelines for Quality Assurance in
- Men and women from 50
age should participate in colorectal screening. This
should be within programmes with built-in quality assurance
Participate in vaccination
programmes against Hepatitis B Virus infection
was supported by the Europe Against Cancer programme of the European
SAINT SILUAN* WARNING SIGNS FOR CANCER IN CHILDREN
Siluan was a Russian monk who died on Mount Athos in 1938. He
prayed ceaselessly for all humanity.
Dissemination of the Saint Siluan warning signs is an initiative
ICCCPO in cooperation with SIOP.
When adequately treated, approximately 70% of
childhood cancers are curable. However, today only 20% of the world's
children benefit from advanced medical care.
Facts about Childhood Cancer
Children living in the underdeveloped countries
account for 80% of the world's population of children. Some of these
children have cancer and are currently denied the right to hope for a
The ICCCPO exists so that the parents of these
children have access to the information they require to make educated
decisions about their child's treatment.
Please remember, when searching for
- that every child with cancer
financial or social class, race or native origin deserves access to the
best possible treatment and medical care,
- results may include links to
to adult cancers; these are often quite different to childhood cancers
even though they may have identical or similar names,
- results may include information
different audiences; for example information for ocologists often
assumes a great deal of prior knowledge and specialist education,
- the search term may include a
word that is spelt
differently in American and UK English (eg. Leukemia vs. Leukaemia,
tumor vs. tumour),
- the quality of information on the
variable; users should be aware of source reliability issues.
Parents are strongly advised to discuss their
information requirements with their doctor, who knows their child's
with cancer need everyone's help!
The global cancer burden
Cancer is largely preventable and the most curable of major
life-threatening diseases today.
By applying existing evidence-based knowledge it is possible to prevent
at least one-third of
the estimated 11 million cancer cases that occur globally each year and
with early detection and treatment, it is possible to cure at least
another third of cancer cases.
However, in spite of the unprecedented understanding of the root causes
of cancer, the gap between what is scientifically feasible and what is
being applied continues to widen.
In 2005 alone, almost 7 million
people died of cancer and close to 11 million new cases were diagnosed.
Cancer claims twice as many lives worldwide as AIDS. In fact, more than 12% of all deaths
every year are caused by cancer. That’s more than AIDS,
tuberculosis, and malaria put together.
In industrialized countries, cancer is the leading cause of premature
mortality, and evidence points to the emergence of the same trend in
Knowledge about the prevention
and treatment of cancer has significantly increased, but the numbers of
people diagnosed with cancer each year and those who eventually die
from it are growing
dramatically. Worldwide cancer control can only be effective if it is
given priority at the highest decision-making levels. Complacency and
inaction on the part of the international community will effectively
contribute to more than 10 million deaths annually by the year 2020.
developing countries, 80 to 90 percent of cancer patients already
suffer from advanced and incurable clinical complications at the time
of diagnosis. Transfer of knowledge must actively be promoted between
peoples of industrialized economies and those who live in
resource-limited settings. Best practices and lessons learned on
cancer-control strategies need to have a regular forum. Clever science
in tandem with sound policies based on evidence can lead to a reduction
in the global cancer burden.
knows no boundaries. It not only affects the quality of life of the
person living with the disease but also adversely impacts the
psychosocial welfare of entire families. Its effects can be
wide-ranging and a downward spiral can result with huge economic
implications. Cancer is capable of inflicting a massive and often
irreversible shock on the most vulnerable: young children, adolescents
as well as persons whose families depend on them for basic survival.
fight against cancer is at a turning-point. In close partnership with
patient and survivor support networks, and national cancer societies,
the International Union Against Cancer (UICC) is in a unique position
to pool resources and expertise to contain the further spread of this
The time to act is now !
What is cancer?
Cancer is a disease that affects many people.
Many people are frightened when they hear about cancer. This fear some
times discourages people from becoming informed and doing what they can
to help prevent cancer. Learning more about cancer is a way to cope
with the fear of cancer.
Cancer is a group of many diseases that are due to abnormal functioning
of the body cells. The human body is made up of billions of these tiny
cells. These cells form all parts of the body, skin, bones, heart,
lungs, and other organs. Normally, these cells reproduce themselves to
support the growth and repair of the body parts.
When a cell begins reproducing or dividing without the normal order,
pattern or purpose, we call this a tumor. A tumor may be benign (not
cancerous) or malignant (cancerous). A benign tumor may grow larger,
but it does not spread to other parts of the body. It may cause serious
problems, a blockage or appear unusual, but it usually can be removed
and does not grow back.
A malignant tumor is cancerous. The tumor invades nearby parts of the
body. It can spread to other parts of the body forming new tumors (this
is called metastasis). In a malignant tumor, the cells are growing
completely out of control.
In some cases, even when the original tumor is removed by surgery, the
disease may continue to grow where it began or in other parts of the
body if cancer cells already have spread.
What causes cancer?
Cancer occurs when there are changes in the
part of the cell that controls reproduction or division of the cell.
These changes can be caused by infection, like Hepatitis B, or by
exposure to smoking. Scientists agree that people develop certain
cancers through repeated or long term contact with one or more cancer
causing substances called carcinogens. Carcinogens cause body cells to
grow abnormally. Examples of carcinogens include some pesticides,
radiation, chemical toxins, and tar in cigarettes. In addition, smoking
cigarettes too much may cause
you to have lung, throat or bladder cancer. For some cancers, such as
colon, prostate, breast or brain the causes are not clear, and we do
not know why patients with these types of cancer get the disease when
other people do not.
Treatment of hepatitis (liver disease), avoiding sunburns, or quitting
smoking will reduce the chance of getting cancer from these causes.
Early testing (screening) to look for cancer early (when it is small
and has not spread to other parts of the body) can allow for treatments
which will cure the cancer, preventing death from cancer.
Some of the infections that may cause cancer can be contagious, but
cancer itself is not contagious. You won’t get cancer by being around
someone who has cancer.
Some types of cancer, like breast or colon cancers, run in the family.
The risk of getting these types of cancer may be higher for you if
other relatives in your family had that type of cancer before. You can
help yourself by getting tested early for the types of cancers that are
common in your family.
signs of cancer include:
- Losing a lot of weight without trying
- A cough that won’t go away and that is not TB
- Coughing blood, vomiting blood, or passing blood in the
- Blood coming from the vagina that is not menstruation
- Unusual changes in moles or skin
- Skin wound that will not heal
- Feeling very tired and weak without reason
- Lumps or growths
- Unexplained pain
Having these warning signs does not mean you have cancer. The signs may
be caused by other things. If you have one or more of these signs,
check with a doctor to know why.
health care and cancer treatment – Doing things to keep healthy
Preventive health care is very important. It is necessary to eat the
right foods, exercise and pay attention to your body if you want to be
healthy. It is also very important for you to see your doctor as soon
as you find any of the cancer warning signs, or any other health
problems. Your doctor may recommend a test to find
cancer early before you have warning signs and, when a cancer is easier
Your doctor may find that you do not have cancer, but finding the
disease at an early stage improves the chances of cure or control.
There are many different kinds of cancer. Some cancers are easier to
treat than others. The treatment of cancer is improving. Old cancer
treatments caused lots of side effects and were very difficult for
patients. Now, there are many new and more effective cancer treatments.
If cancer is found early, doctors can use these new treatments which
are less troublesome and easier for patients. If cancer is
found early, doctors have a better chance of successfully curing the
Having cancer does not mean that you are fated to die from cancer, or
that it is God’s will that you die from cancer. People who have cancer
can often be cured, so that they do not die from cancer. If you have
cancer, do not give up. It is important to seek treatment because most
cancers can be treated.
If you have questions about the information you see here, or if you
want to learn more about cancer and early testing, contact your family
doctor for an appointment. If you believe you may have some unusual
signs and believe they represent early signs of cancer, you should make
an appointment with your doctor.
Adapted from the American Cancer Society pamphlet:
WHAT YOU NEED TO KNOW ABOUT CANCER by Harborview Medical Center,
AANCART and House Calls programs. Translation made possible by The
Information Project, funded by the National Library of Medicine.
PREVENTING BOWEL CANCER
of people a year could be saved from developing bowel (colon) cancer -
if only they knew how.
Here are our Top Ten Tips - they won’t help everyone but will save many
1. The wonders of walking - especially brisk walking. Daily walks (at
least 30 minutes) boost the immune system, make our insides work more
efficiently and help keep down fatty cells around our middle as we get
older - these cells increase insulin which can encourage cancers to
develop around the body.
2. You are what you eat - cut back on red meat, processed and fatty
foods, step up wholemeal bread/pasta, oily fish, fruit and veg and
you’ll really improve your chances of avoiding bowel cancer.
3. Older & wiser - most people who get bowel cancer are over 50 so
the older you are, the more aware you need to be. Screening is the best
way to catch it early. From April 2006 the over 60s will be offered
free bowel cancer screening - it’ll be wise to accept
4. Weight watchers win - being fat increases your risk. Even if you’re
fit and fat, you’re still at increased risk of bowel cancer. Big
breakfast, middle sized lunch, small dinner, only fruit as snacks
between meals - with exercise, it’s the best way to lose weight
5. Ask your granny - if there is any bowel cancer or other cancers in
your family. Having close relatives affected can dramatically increase
your risk - click on Family History to find out more
6 Know your onions - veg from the allium family (onion, garlic, leeks
..) are thought to protect the gut against cancer and it’s good advice
to eat lots. Latest research looks good for watercress and broccoli too.
7 Think alternatives to aspirin - research shows aspirin can stop early
cancers developing but get your doctor’s advice before you take it. A
great alternative - organic green veg: they develop natural aspirin
(salicylic acid) to help fight off plant diseases
8. Smoking & drinking - no surprise that smoking and heavy
drinking, especially beer & spirits, can increase your chances of
getting bowel cancer. To stop smoking, try the Quitline 0800 002200.
Exercise helps to cut cravings; serious drinkers, contact
www.al-anonuk.org.uk - serious smokers Quitline 0800 002200
9. Listen to your insides - ulcerative colitis, Crohn’s disease,
inflammatory bowel disease, a history of polyps - bowel problems like
these can lead to bowel cancer, especially if you developed them young
or have had them a long time. Make sure your GP gets you monitored
10. Don’t sit on symptoms - millions of us have bleeding from the
bottom and changes in our bowel movements every year. Get to know which
are important and how to test them to see if serious before going to
your GP - ring our 24-hour recorded symptoms hotline - 0870 24 24 870
or get our Step by Step guide, free from Lynn’s Bowel Cancer Campaign,
address below. Pick up symptoms earlier and you might live longer.
cancer is the commonest cancer in Europe and the second highest cancer
killer in the UK, affecting one in 10 families. I want people to know
that although being told you have cancer can be absolutely terrifying,
it is not necessarily a death sentence. “This certainly applies to
bowel cancer as it is one of the most treatable, curable and beatable
cancers. Be aware of the symptoms and don’t be embarrassed about
speaking to your GP. Being able to spot important symptoms might save
The Rights and
Educational Needs of Sick
1. Every sick child and adolescent has the right to tuition
within hospital or at home.
2. The aim of tuition for sick children and adolescents is the
continuation of education, enabling them to maintain their pupil-role.
3. The hospital school creates a community of children and adolescents,
and normalizes everyday life. Hospital education shall be organized as
class, group or individual teaching and at the bedside.
4. Hospital and home tuition must be adapted to the needs and abilities
of the child or adolescent in co-operation with the home school.
5. The learning environment and facilities must be adapted to the needs
of sick children and adolescents, and communication technologies shall
also be used to prevent isolation.
6. A variety of teaching methods and resources shall be used. The
content encompasses more than formal curriculum learning. It includes
subjects related to special needs arising from illness and
7. The hospital and home tuition teachers must be fully qualified and
receive further training.
8. The teachers of sick children and adolescents are full members of
the multi-disciplinary caring team and are the link between the
hospitalized child or adolescent and the home school.
9. Parents must be informed about the right to schooling and the
educational program of their sick child or adolescent. They shall be
recognized as active and responsible partners.
10. The integrity of the child or adolescent shall be respected
including medical confidentiality and private convictions.
Adopted by the General Assembly of HOPE
Barcelona - 20th May 2000
rights and responsibilities
Everyone has a right to expect quality care while in hospital. Hospital
staff and parents have a special duty of care to children and a legal
responsibility to protect the child’s rights, interests and wishes.
This is dependent on their age, understanding and the treatment they
are having (this may differ in Scotland).
While in hospital:
• to receive treatment on the basis of clinical need.
• courtesy and respect for privacy and dignity.
• treatment in a children’s hospital, unit or ward that is right for
their age and medical condition, with play and education available.
• nursing care by appropriately trained children’s nurses.
• to be involved in discussions (if they are able to understand) and
consideration to be given to their wishes.
• an introduction to the staff caring for them.
• their operation to be carried out by, or under the supervision of, a
surgeon with appropriate training and experience in the care of
• anaesthetic from an anaesthetist who is trained and experienced in
the care of children.
As the parent or guardian
of a child you can expect…
• to be with your child during treatment, unless it puts either of you
at risk, and to stay overnight if you wish.
• to choose to have a relative or friend with you during consultations
• to be given time to ask questions about your child’s medical problems
and suggested treatment and to get clear information about them (ask if
written information is available).
• to be given a name and telephone number of someone you can ring if
you have any other questions.
• to take part in all decisions about treatment and aftercare and to
have the pros and cons, including any risks, side effects and
alternative methods of treatment fully explained to you.
• to be informed day or night of any worsening in your child’s
• staff to understand you may be feeling worried or nervous and this
may affect the way you or your child behave.
• to be told if there is a delay when you arrive for an appointment,
how long you may have to wait and why.
• to know the names, jobs and professional status of the staff involved
in your child’s care.
• to have all details about you and your child treated in confi dence
(except where required by law) and for your permission to be obtained
before any details can be shared with anyone else.
• to have the right to see any information kept about your child and
• to complain if you are unhappy with the treatment you or your child
• to be given an explanation and, where appropriate, an apology, if
things do not go as planned.
• to choose whether or not your child may be seen by medical students.
You and your child
have a responsibility…
• to treat all staff, other patients and families with courtesy and
• to let the hospitals know at once if you change your address or
• to understand that there are pressures of time and resources on the
NHS and those working within it.
• to give staff full information about your child’s condition and to
let the staff know if your child has any physical or learning
disabilities, allergies, sensitivities, conditions or changes in their
health and of any medicines they are taking, including over the counter
• to tell staff if your child is being, or has been, treated by other
health care professionals that might be relevant to present treatment.
• to tell staff if you do not understand or are uncertain about any
part of the diagnosis or treatment and ask for more information or
clearer explanation (in writing if it helps).
• to follow the instructions given to you on the care of your child
before going into hospital for an operation.
• to make sure that your child follows the advice on what to do after
the operation (eg exercise, diet, etc); takes any medicine as
instructed; and seeks medical advice before stopping or changing
• to think about and be aware of what might happen if you or your child
recommended treatment or do not follow the doctors’ advice and accept
responsibility for those actions and the subsequent results for your
• to ensure that your child attends follow-up appointments and that all
appointments are attended on time or that cancellation (with reasonable
notice) is arranged.
• to make sure you, your child and all accompanying visitors follow all
the hospital and ward rules.
©The Patient Liaison Group at The Royal College of Surgeons of
Contact the PLG on tel: 020 7869 6045; fax: 020 7869 6045; or see the
website at www.rcseng.ac.uk/welcome/information_for_patients_liaison/
Children Patient' s
Young people aged 16 or over but under 18 can give independent consent
to their own treatment. It is not necessary to obtain the consent of a
parent or guardian. A young person can be overruled by a court order.
However, if the young person is incapable of giving their own consent,
for example, they are severely disabled, the parent’s or guardian’s
consent must be obtained.
Children under 16 can give their own consent to treatment provided they
are judged capable by a doctor, Primary Care Trust or NHS Trust, of
understanding what is involved. There is no general test for assessing
this capacity, and each case will be decided on its own merits.
If a child under 16 does not have sufficient understanding, parental
consent (or a court order) will be required for any treatment, except
in an emergency. If a child under 16 who does have sufficient
understanding refuses treatment, treatment can still be given with
their parent’s or guardian’s consent or by a court order.
Young people or children under 18 cannot give their own consent to
experimental operations and blood donations, unless they have
sufficient understanding of what is involved.
In Scotland, a child under 16 can consent to, or refuse, any treatment
if the qualified medical practitioner attending them believes they are
capable of understanding the nature and possible consequences of the
treatment. Parental consent should be obtained where a child under 16
does not have sufficient understanding, except in an emergency where
there is not time to obtain it. If the local authority holds parental
responsibility for a child under 16, consent from a parent or guardian
does not need to be sought.
In Northern Ireland, a parent's consent may be required for any medical
treatment for a young person aged under 16. However, in practice, if
the young person understands the implications of the treatment
involved, they can consent to, or refuse, medical treatment themselves.
A young person over 16, if competent, can give their own consent to
treatment, although most hospitals will require parental permission to
perform an operation on a young person under 18.
You refuse treatment for your child
If you, a guardian or child refuse to give consent for treatment which
a doctor thinks is necessary, the doctor is still obliged to treat the
child. The action the doctor takes will depend on how urgently the
treatment is needed.
When a child’s life is in danger, the doctor has the right to do
whatever is needed to save the child’s life. If you or a guardian
either fail to provide medical help for a child, or unreasonably refuse
to allow treatment, you can be prosecuted for neglect.
There may be a number of issues which you may wish to consider if your
child is to go into hospital, for example, whether you can stay with
your child, how much help you can give with feeding and looking after
your child and what will happen to your child’s education. Action for
Sick Children may be able to advise on all these issues. It also
produces a leaflet for parents whose child is going into hospital for
the first time.
Processed meat consumption
results in 67%
increase in pancreatic cancer risk, says new research!!!
European Prospective Investigation
into Cancer and Nutrition
EPIC: Diet nutrition and cancer
to the American Institute for Cancer Research (AICR), the world's most
comprehensive cancer study being conducted in establishing the link
between diet and cancer risk has been going on for over a decade and
few people hear about it. Over 80 scientific papers based on the study
have been published in journals such as the Journal of the National
Cancer Institute, the Lancet, the Journal of Nutrition.
The study -- called the European Prospective Investigation into Cancer
and Nutrition (EPIC) -- is an enormous undertaking involving 521,483
individuals in 10 different European countries. EPIC is unique because
the populations being tracked are so diverse in eating habits. But this
is precisely what gives the study the advantage it has in making
comparisons and noting trends.
According to EPIC, a few of the emerging results found in the link
between diet and cancer are:
Consumption of meat sharply increased risk of stomach cancer and
esophageal cancer. For every 100 grams of meat consumed by subjects,
risk for stomach cancer more than tripled. The association between meat
intake and stomach cancer was considerably stronger among subjects with
populations of H. pylori bacteria in their stomachs.
Two indicators of abdominal obesity, waist circumference and
waist-to-hip ratio, were strongly associated with colon cancer risk in
both sexes. Men with the largest waist circumference had 39 percent
higher risk of colon cancer than men with the smallest, for example,
while women in the study with the largest waist circumference has a 48
percent higher risk than women with the smallest waists.
Blood samples of women with breast cancer were compared to blood
samples of women without breast cancer. Women over 60 whose blood was
given under non-fasting conditions, high levels of serum C-peptide,
that could reflect insulin resistance -- long suspected of contributing
to cancer risk -- was associated with a doubling of breast cancer risk.
The risk for oral and pharyngeal cancers drop by 9 percent for every 80
grams of fruits and vegetables consumed per day.
Researchers are beginning to come to some conclusions involving the
data they have to date that clearly shows that globally, diets that are
high in fruits, vegetables, fiber and fish are associated with greater
cancer prevention -- with obesity and sedentary lifestyles much larger
factors in increasing cancer risk.
Investigation into Cancer and Nutrition
The European Prospective Investigation
into Cancer and Nutrition (EPIC) is coordinated by Dr Elio Riboli,
Chief of the Nutrition and Hormones Group at the International Agency
for Research on Cancer (IARC, which is part of the World Health
Organization) in Lyon, France. EPIC received substantial financial
support from the Europe Against Cancer Program of the European
EPIC was designed to investigate the relationships
between diet, nutritional status, lifestyle and environmental factors
and the incidence of cancer and other chronic diseases. EPIC is the
largest study of diet and health ever undertaken, having recruited over
half a million (520,000) people in ten European countries: Denmark,
France, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden
and the United Kingdom (select a country from the map).
Within these countries EPIC research scientists are
based in 23 centres: one in France (Paris), Greece (Athens) and Norway
(Tromsø), two in Denmark (Aarhus and Copenhagen), Germany
(Heidelberg and Potsdam), Sweden (Malmo and Umea), the Netherlands
(Bilthoven and Utrecht) and the United Kingdom (Cambridge and Oxford),
five in Italy (Florence, Milan, Naples, Ragusa and Turin) and Spain
(Granada, Murcia, Asturias, Pamplona, and San Sebastian with Barcelona
the co-ordination centre). Originally there were 7 countries involved
but between 1995 and 2000 Sweden, Denmark and Norway, which were
already involved in similar studies, joined EPIC and thus broadened the
European cohort to include Scandinavian populations.
Recruitment into the study, which was initiated in 1992, was
principally from the general population aged 20 years or over, and took
place between 1993 and 1999. Detailed information on diet and lifestyle
was obtained by questionnaire, and anthropometric measurements and
blood samples were taken at recruitment. The blood is stored in liquid
nitrogen for future analyses. By studying very many people in different
countries with differing diets, using carefully designed and tested
questionnaires, EPIC should produce much more specific information
about the effect of diet on long-term health than any previous study.
The first results were presented in June 2001 at the European
Conference on Nutrition and Cancer and the conference proceedings have
been published in Riboli E., Lambert A. (eds) : Nutrition and lifestyle
: Opportunities for Cancer Prevention. IARC Sci. Publ. No.156. 2002.
It is planned to follow-up the study participants for the next 10 years
at least, continuing to study the role of nutrition and lifestyle in
cancer development and other chronic diseases. The EPIC Newsletter can
be found here.
In September 2001 the 5 A Day Initiative project, under the auspices of
the German Cancer Society in Frankfurt, Germany entered into a
collaborative research agreement with the EPIC study.
Investigation into Cancer and Nutrition
The European Prospective Investigation into Cancer and Nutrition (EPIC)
study is a Europe-wide prospective cohort study of the relationships
between diet and cancer, as well as other chronic diseases, such as
cardiovascular disease. With over half a million participants, it is
the largest study of diet and disease to be undertaken.
EPIC is coordinated by the International Agency for Research on Cancer
(IARC), part of the World Health Organization, and funded by the
'Europe Against Cancer' programme of the European Commission as well as
multiple nation-specific grants and charities.
521,457 healthy adults, mostly aged 35-70 years, were enrolled in 23
centres in ten European countries: Denmark (11%), France (14%), Germany
(10%), Greece (5%), Italy (9%), The Netherlands (8%), Norway (7%),
Spain (8%), Sweden (10%) and the United Kingdom (17%). One UK centre
(Oxford) recruited 27,000 vegetarians and vegans; this subgroup forms
the largest study of this dietary group. Recruitment to the study took
place between 1993 and 1999, and follow up is planned for at least ten
years, with repeat interview/questionnaires every three to five years.
The main prospective data collected are standardised dietary
questionnaires (self administered or interview based), seven-day food
diaries, blood samples and anthropometric measurements, such as body
mass index and waist-to-hip ratio. Additionally, the GenAir
case-control study is studying the relationship of passive smoking and
air pollution with cancers and respiratory diseases.
Up to 2004, there were over 26,000 new cases of cancer recorded among
participants, with the most common being cancers of the breast,
colorectum, prostate and lung. Current analyses are focusing
particularly on stomach, colorectal, breast, prostate and lung cancers.
The different dietary patterns in the different countries should enable
reliable associations to be made between particular diets and cancers.
The analysis of stored blood samples should also allow dissection of
genetic factors involved in cancers, as well as the effects of hormones
and hormone-like factors.
of fibre, fish, milk and cheese reduce risk of colorectal cancer, while
red and processed meat
Consumption of fruit and vegetables does not affect risk of breast or
Meat, Fish, and
Colorectal Cancer Risk: The European Prospective Investigation into
Cancer and Nutrition
Recommandations from BRISTOL CANCER HELP CENTRE, got for Association P.A.V.E.L., by: Dr.
Luiza Dihoru, Dept. of Civil Engineering, University of Bristol
Malnutrition is common in
adults and children with
cancer and evidence clearly shows that this can have a negative impact
on how effective a person’s medical treatment is for them and also how
well they are able to tolerate the treatment. A healthy eating plan can
help to protect against malnutrition and also ensure the body receives
adequate levels of nutrients that support the body’s immune and repair
functions, both of which can become weakened due to the disease or its
necessary medical treatments.
The Bristol Approach to
research highlights the powerful
anti-cancer properties of many foods and indicates that a healthy diet
can be very beneficial for people diagnosed with cancer. This sheet
provides a general overview of our healthy eating recommendations and
includes lists of foods that we encourage people to eat plenty of, the
foods we suggest in moderation and those we would encourage people to
minimise. These are presented alongside practical suggestions on how to
add healthy foods high in anti-cancer agents into the daily diet, while
gradually cutting down on or avoiding those foods containing compounds
that may undermine health. Please note that those with specific
nutritional needs should seek the advice of a health professional
before changing their diet.
Although what we
eat and drink is very
important, there are also many other changes that can be made to
improve quality of life and to support health and well-being. It
is very natural that adults and children may experience increased
stress levels after a diagnosis of cancer, but this stress can prevent
the immune system, a most vital system of defense against disease, from
working at its best. We therefore feel that learning practical
techniques to reduce stress levels is just as important as following a
healthy way of eating.
Eating for Children
diet that would be most
supportive to the health of adults would also be the one most
supportive to the health of children. The focus with both adults and
children is on the use of whole foods, which are those with as little
added or taken away as possible. While it is often assumed that
children will not be happy to eat wholesome foods, there are many ways
to make vegetables, fruits, wholegrains, nuts and seeds and pulses
appealing to children. Ideas include fresh fruit juices and smoothies,
burgers made with beans, lentils and good quality fresh meat, potato
chips prepared by baking slices of fresh potatoes in olive oil,
vegetable soups etc.
should be encouraged to cook meals for
their children that are based on a wide variety of fresh ingredients
and to experiment with new foods. If children do not accept the new
foods at first it is worth persevering. However, one very important
point is that children should not be forced to eat foods that they
don’t like as stressful mealtimes are not helpful to parents or
children. The key thing is to make the foods and the eating experience
as fun and exciting as possible and one way to do this is to involve
children in the food preparation. Also families should be encouraged to
sit down around a table and eat their meals together.
- the most important thing to
remember is that food should always be a
pleasure. The way we feel emotionally as we eat has a significant
impact on the way we digest and absorb the food and we should try, if
possible, to eat in a relaxed environment. Feelings of stress due to a
dislike of the food will undermine the nourishment we are receiving and
it is therefore important not to feel too pressured by thoughts of what
should and should not be eaten.
at the same time that it
is important to enjoy the diet, it is vital to
include as many of the healthiest foods as possible on a regular basis.
We encourage people to experiment and find ways of preparing and
cooking food that is healthy and delicious.
changes - when
introducing changes to the diet, do so in a
step-wise fashion. It is important not to make lots of changes at once
as it is easy to become overwhelmed, which can lead to helplessness and
a desire to give up on the healthy eating plan altogether.
– it is essential to eat a
varied diet not only to ensure a balanced
intake of all essential nutrients but also to avoid becoming bored with
the eating plan.
Eat Plenty Of
· Organic foods – use organic
foods whenever availability and budget allow in order to limit exposure
to potentially toxic pesticides and hormones.
· Whole foods – whole foods are
those with as little added or taken away as possible. Stick to foods
that are unprocessed, i.e. no ‘ready meals’, and unrefined, i.e. use
whole grain products such as wholemeal bread or pasta rather than the
· Fresh vegetables and fruit –
choose those that are in season and locally grown if possible. You
should aim to have 8-10 portions per day (7-8 portions for children)
with at least 5 portions of vegetables and 3 of fruit. Eat some of
these raw and either lightly steam or bake the rest. Eat a variety of
vegetables and fruit in a rainbow of colours.
· Whole grains – include whole
grains and whole grain products in the diet on a regular basis.
Examples include barley, rye, wheat, rice and oats.
· Pulses – include a variety of
cooked and sprouted beans, peas and lentils.
· Healthy fats – use cold pressed
vegetable oils for salad dressings and extra virgin olive oil or
coconut oil for cooking. Olive oil can be drizzled over bread or toast
in place of spreads. If this is not acceptable use non-dairy margarine
free from hydrogenated/trans fats. Nuts and seeds plus oily fish are
good sources of the essential fatty acids.
· Juices - freshly prepared juices
are a great way of boosting nutrient intake. Use mainly vegetables with
a little fruit to sweeten.
· Water - drink lots of water
aiming for around 1.5-2 litres per day (around 1 litre for children).
If possible, aim to use spring or mineral water or water that has been
Eat in Moderation
· Poultry – chicken and turkey
(organic, if possible).
· Eggs – chicken, duck or quail
(free range and organic, if possible).
· Fish – choose non-farmed,
deep-sea white fish such as cod and haddock and the smaller oily fish
such as sardines, pilchards and herring.
note: we suggest people consume small portions of animal
products, about the size of the palm of the hand, around 3 times per
week, or every other day. For children we would recommend a piece of
meat, fish or an egg every day. We also strongly recommend buying the
best quality products whenever possible, ideally organic. People who
choose not to eat animal products should be very careful in ensuring
they consume adequate protein from a plant-based source and to help we
would recommend they seek the advice of a nutritionist.
· Red meat – e.g. beef, pork or
· Dairy products - milk, cheese,
cream or yoghurt (non-dairy alternatives are available).
· Smoked and salt cured foods
· Barbequed, char-grilled or burnt foods
· Refined sugars – avoid all
sugary foods and use fruit (primarily fresh but also dried, if desired)
to add sweetness to the diet. Honey or maple and fruit syrups can be
used occasionally, if necessary.
· Processed foods - e.g.
pre-prepared meals and convenience foods.
· Table salt – use small amounts
of tamari sauce or rock/sea salt instead.
· Hydrogenated or trans fats –
found in many convenience foods, vegetable oils and margarines. Use
cold-pressed vegetable oils and margarines free from trans fats.
· Begin your
changes by increasing your intake of fresh organic vegetables and
fruit. Follow this with an increase of the whole grains, pulses and
nuts and seeds so that plant foods form the bulk of your diet.
· A good way to
ensure you are eating a variety of vegetables and fruit is to aim for a
‘rainbow diet’, i.e. a range of richly coloured foods. The bright
colours will also makes a meal look particularly appetising.
· Gradually replace
dairy products with alternatives such as rice, nut, oat or soya milk.
This does not mean that you have to do without creamy food as nut based
products are good for creams and puddings. Large amounts of soya
products (more than once per day) are not recommended.
· Juicing is a great
way of getting the goodness and nutrients from a wide variety of
vegetables and fruit into your diet. Nutrients in fresh juices are
easily absorbed and therefore juicing is useful for those with poor
digestion. To avoid high levels of fruit sugars, use mainly
vegetables with a little fruit to sweeten.
· If you are unable
to obtain organic vegetables or fruit, use non-organic but make sure
you wash them properly. To help remove surface pesticides, soak them
for 15 minutes in water mixed with one tablespoon of vinegar before use.
· Try not to rely on
wheat products too much. Instead experiment with the other more unusual
whole grains such as rice, corn, buckwheat, rye or barley.
· Use the following
to add flavour to dishes without the use of salt: herbs (fresh and
dried), spices, lemon and lime, tomato paste, tamari sauce, garlic,
ginger, dried mushrooms and dried tomatoes.
· If possible, cook
in bulk and then freeze individual portions for when you are busy or
don’t feel well enough to cook.
· Main meals can take
a little planning, especially if you are cooking for a family.
Ensure that you have a few good healthy-eating cookbooks to inspire
· If you are not used
to eating meals that are free from animal products, start slowly by
having one meal of this type a week. Gradually include more of these
meals as you build up your repertoire of recipes and your confidence in
cooking this way.
· Grow your own
sprouts from pulses (lentils, peas and beans) and seeds. It is cheap
and easy to do, and the sprouts are highly nutritious. They can be
eaten raw or lightly steamed or stir-fried.
Changing the way you eat can feel a little
daunting at first. To help you plan your new menu here are a few ideas
for breakfast, lunch and dinner, as well as ideas for snacks.
– fruit salads using fresh or cooked dried fruits;
wholegrain toast with sugar-free fruit preserve, nut butters (e.g.
almond or hazelnut), scrambled egg, tomatoes or mushrooms; porridge or
muesli with fruit and nuts and seeds, made using non-dairy milk; fruit
smoothies (a particular favourite with children).
– mixed salad using a variety of fresh raw vegetables and fruit; fresh
soups; jacket potato or wholegrain sandwich with beans, hummous, lentil
pate, nut butters, sardines; cooked grain salad using barley, bulgar
wheat, buckwheat, brown rice etc.
meal – vegetable casserole; vegetable curry; lentil cottage pie;
tofu stir-fry, fish or organic chicken with vegetables. Burgers made
with beans, lentils and good quality meat or white fish coated in bread
crumbs and baked are good ideas for children.
– nuts and seeds; fresh or dried fruit; chopped raw vegetables plus
hummous or avocado dip; oatcakes, rye crackers, rice cakes or
wholegrain toast plus lentil pate.
Supplements provide nutritional back-up to
good diet but the focus of a nutritional approach should always be the
foods, as supplements can never replace a healthy diet.
The key supplements that we recommend for
people with cancer are listed below with the reasons why they are
· Multivitamin and mineral – it is
particularly important to supplement minerals as soil levels of these
vital nutrients have declined significantly over the past few decades
due to intensive agricultural practices. Formulations designed for
children are readily available.
· Antioxidant – antioxidants help
protect the body against excess free radical activity, which is
implicated in cancer development and progression. Many different
nutrients possess antioxidant activity and it is advisable to take a
supplement containing a range of these nutrients such as vitamins C and
E, zinc, beta carotene etc. as they have synergistic actions working
together more powerfully as a group. Formulations designed for children
are available, alternatively half the dose of an adult formulation
could be used for those under 12 years.
· Fish oils – fish oils are rich
in essential fats called omega 3 fats, these are very supportive to
health, in particular for people with chronic diseases. Children under
12 years should take half the adult dose.
· Probiotics – these are bacteria
that are beneficial for the health of the gut. They help ensure
digestion and absorption of nutrients is efficient and they promote
health in other ways including supporting the immune system.
It is recommended that people stop taking all
supplements 2 days before they have a dose of chemotherapy and restart
them 2 days after their dose of chemotherapy.
19 Martie 2006
Right to Health
CESCR General Comment No.14 on the Right to Health
UN Special Rapporteur on the Right to Health, Paul Hunt
The Right to Health: A Resource Manual for NGOs; By: Judith Asher
The Right to Health as a Human Right in International Law; Brigit
Toebes, School of Human Rights Research Series, Volume 1, Hart
Intersentia, Antwerpen- Groningen-Oxford, 1999
The ‘Right to Health’ in European Union Law, in: Economic and Social
Rigths under the EU Charter of Fundamental Rigths, Hervey and Kenner
eds., Hart Publishing, Oxford-Portland Oregon, 2003
International Federation of Health and Human Rights Organisations
The Lymphoma Coalition
is a non-profit network organisation of lymphoma patient groups, which
was established in 2003. It is a global initiative, which
currently has 27 members worldwide, dedicated to increasing awareness
of lymphoma, and promoting the well-being of people affected by