Introduction
Reducing the risk of certain cancers may be possible through dietary and other lifestyle changes. How risk can be reduced depends on the specific cancer. For example, not smoking and avoiding exposure to tobacco smoke can greatly reduce the risk of lung, kidney, bladder, and head and neck cancer. Avoiding the use of smokeless tobacco (snuff, chew) decreases the risk of cancer of the mouth and tongue. Avoiding sun exposure (especially during the middle of the day) can reduce the risk of skin cancer. Covering exposed skin and using sunblock lotion with a high sun protection factor (SPF) against ultraviolet light also helps reduce the risk of skin cancer.
Other lifestyle changes reduce the risk of several types of cancer. A reduced intake of fat in the diet appears to decrease the risk of breast and colon cancer. Use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) reduces the risk of colon cancer.
 See the sidebar Preventing Cancer.
Treating cancer is one of the most complex aspects of medical care. It involves a team that encompasses many types of doctors working together (for example, primary care doctors, gynecologists, oncologists, surgeons, radiotherapists, and pathologists) and many other types of health care workers (for example, nurses, physiotherapists, social workers, and pharmacists). Treatment decisions take into account many factors, including the likelihood of cure or of prolonging life when cure is not possible, the effect of treatment on symptoms, the side effects of treatment, and the person's wishes regarding all of these issues. People undergoing cancer treatment hope for the best outcome and the longest survival with the highest quality of life. However, people who are candidates for radiation therapy or anti-cancer drugs must understand the risks involved with treatment. People with cancer should discuss their wishes regarding medical care with all of their doctors, including the level of treatment desired when no cure is possible (see Section 1, Chapter 9).
When the diagnosis of cancer is first made, the main goals of treatment are to remove the cancer if possible (through a single treatment or a combination of surgery, radiation therapy, or chemotherapy) and reduce the chance of spread (metastases). Chemotherapy is usually the only way to treat the cancer cells that have spread beyond the original (primary) site. Using combinations of chemotherapy drugs may help eradicate the original cancer and kill cancer cells elsewhere in the body.
Even when a cure is impossible, symptoms resulting from the cancer can often be relieved with treatment that improves the quality and length of life (palliative therapy). For example, if a tumor cannot be removed surgically, radiation of the tumor may shrink it, temporarily reducing pain and symptoms in the immediate vicinity of the tumor (local symptoms).
As treatments become more complex, specific approaches to care, called treatment protocols, have been developed for many types of cancer to ensure that people receive the most effective care with the fewest side effects. Thus, the use of treatment protocols assures that people with the same type and stage of cancer are treated with some standard sequence and dose of therapies. Such protocols are derived from careful scientific experiments. Protocols are constantly being refined to improve their effectiveness.
See the sidebar Response to Treatment.
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