Office jobs are a diverse family; you might be a receptionist, an accountant, a marketing director, or you might even be a blog writing aficionado. Within the variety of roles that are available, there is a common physical restriction; sitting down. Many of us will relish in the fact that sitting down is part of our job, but don’t get too comfortable; the European Code Against Cancer (ECAC) have explored the health risks of sedentary behaviour and suggest that any type of physical activity is advantageous to our health.
In 2007, the International Agency for Research on Cancer|World Health Organization (IARC|WHO) concluded that the effects of shift work on the disruption of normal circadian rhythm had a probable link to breast cancer. IARC suggest that our endogenous 24-hour body clocks may be subject to interference by factors such as exposure to light at night, and it’s impact on melatonin levels may be linked to breast cancer. However, a recent meta-analysis led by Dr Ruth C. Travis published in the Journal of the National Cancer Institute concludes that night shift work may actually have very little effect on breast cancer risk.
There aren’t many good things to report about dietary trends in Scotland but one that does stand out is our decreasing consumption of red and processed meat – albeit by a modest amount.
Three years ago I attended my first day at the University of Dundee which didn’t get off to the best start. The first challenge I would face as an aspiring scientist was deciphering my timetable; not an easy task as I end up in the wrong class on the basement level of the building. Realising my mistake I run back up the stairs to the ground floor and think, among the profanities, “Phew! That’s my exercise done for the day“. Catching my breath, I re-read my timetable and see an insolent little “3” staring back at me. The third floor.
Colorectal cancer is the fourth most common cancer in the UK and its incidence is increasing. However, survival rates are also increasing. In Scotland, age-standardised, five year survivorship rates have increased from 42.9% in 1987-91 to 64.7% in 2007-11. More people surviving after a bowel cancer diagnosis is fantastic news, but there is considerable room for improvement in both quantity and quality of years; multi-modal treatment pathways, risk of complications and the possibility of a stoma can cause prolonged physical and psychological recovery.
One strategy for improving quality and duration of survivorship might be through lifestyle interventions. However, conducting trials of lifestyle can be complex, especially if more than one health behaviour is being targeted and a number of long term multi-modal treatment options are utilised. Research funders query the feasibility of undertaking trials in this patient group and demonstrating clinically relevant outcomes.
For a great overview of current randomised control trial (RCT) interventions in this area, a recent paper by Moug et al provides a sharp view of work to date. The review team collated evidence from fourteen peer reviewed papers relating to physical activity and six relating to diet and excess weight. The results demonstrate that interventions on physical activity and/or diet and weight are feasible and acceptable to patients and provide a platform for optimising and advancing work in this area.
The evidence suggests that there is scope for interventions to be performed pre-operatively, post-operatively and even many years later to help improve the lives of survivors. The effects of interventions on psychological, physical, dietary and weight improvements have, however, mostly been studied in the short term. Long term trials need to be developed in order to collect robust evidence to influence policy makers.
Here is an understudied area, yet one that deserves more attention, more support and more funding.
At 50, my youngest daughter made me call the local breast screening centre to ask if I had missed a letter inviting me to attend. She said “the late birthday card from the bowel cancer unit came within weeks of turning 50…” Happily the screening centre staff offered to give me an appointment but said I hadn’t missed an invitation, it was just that my GP area wasn’t being called in at that point in time. I went, got an all clear and had one happy daughter.
The American publication ‘Nutrition Action’’s most recent article highlights issues about women and alcohol by George Koob (Director of the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health), Walter Willet (chair of the Department of Nutrition at the Harvard School of Public Health) and Regina Ziegler (of the Division of Cancer Epidemiology & Genetics at the National Cancer Institute).
ME: Heyyy, big party on Friday, come along!
CLAIRE: Oh yeh thanks, sounds good, but I’ll see how I feel – gotta go for colposcopy Friday morning.
ME: Oh really, I had one recently, wasn’t bad at all and the nurses were really nice! Which hospital you going to?
ME: Och I’m sure they’ll be nice, to be honest the worst bit about colposcopy for me was trying to explain to Chris that I dont have an STD!
CLAIRE: OMG SAME!!!!!!
When I received my last follow up letter after a smear which showed abnormal cells I mentioned to my boyfriend that I’d be doing that in a few weeks so I’d have to take the morning off work. His face fell, what do you mean you’ve got to get tested? How can you have an STD?
I realised this wasn’t going to be the evening we’d planned, well we can see that film at the cinema next week..
I first got Wikipedia up, then explained how we gals have to go do this every few years, and no, it’s not a great experience but hey, prevention is key, and, it’s free! He seemed a bit embarrassed that he had misunderstood the importance of cancer screening but totally got it once I explained that all girls, and women do this, yes even all your friend’s girlfriends (and your mum!).
We girls are pretty good at supporting each other, we are open about our health and don’t have any qualms about chatting about smear tests over cappucinos. But the recent conversation with my boyfriend, and with my friend about her boyfriend’s seemingly unsupportive/confused reaction to cervical cancer screening makes me wonder if a general confusion about cervical cancer testing, compared with more general sexual health screening from the boys might be acting as a barrier to us going for testing.
Fortunately we were able to explain in not too much time to the lads what is going on and why it is important, while the best way to explain to them prior to an encounter like our experiences is not obvious it seems that being prepared to explain is helpful. Of course they want the best for us and want to support us (and their mums) so it is important being open to their questions, without being offended, its not that they are ignorant but men would rarely hear about smear tests in their group chats!
For advice (after looking at Wikipedia!) Jo’s Trust website has a few threads on their forums about men and cervical cancer testing, including male bosses and how to talk to them about getting days off for testing and treatment.
Dr Christopher P. Wild, Director at the WHO International Agency for Research on Cancer (IARC), was in Scotland last week speaking at the Royal Society of Edinburgh on Monday July 10th 2017 in association with the Scottish Cancer Foundation and the Cruden Foundation. He then made his way to Ninewells Hospital and Medical School in Dundee on Tuesday 11th to speak at the annual lecture for the Ninewells Cancer Campaign.