March 5, 2025
I read with great interest the article in the November/December ACS Bulletin, “Clinicians Struggle to Understand Dramatic Rise in Early Onset Colorectal Cancer.” As a surgical breast oncologist who is certified in lifestyle medicine, I am a strong advocate for lifestyle improvements as primary prevention in my practice.
I applaud the article highlighting the importance of colonoscopy and emerging serum screening tools. These secondary prevention modalities are important parts of the puzzle to decrease cancer incidence, but surgeons are also well-positioned to be advocates of primary prevention using our influence to spread the word about the effects of lifestyle factors in cancer development.
As in colorectal cancer, lifestyle factors such as a sedentary lifestyle, alcohol intake, low diet quality, and increased adiposity increase one’s risk of at least postmenopausal breast cancer. Additionally, optimizing these lifestyle factors after a breast cancer diagnosis can markedly decrease recurrence.
In my practice, a lifestyle discussion takes this form:
Much can be accomplished with a few basic scripts (and some practice) and even a short discussion such as this underscores that we, as a cancer center, see lifestyle as integral to our patients' care and optimal health.
Lora Hebert, MD, MPH, FACS, DipABLM
Dignity Health Cancer Institute at St. Joseph's Hospital and Medical Center in Phoenix, AZ
Armenta-Guirado BI, Gonzalez-Rocha A, Merida-Ortega A, et al. Lifestyle quality indices and female breast cancer risk: A systematic review and meta-analysis. Adv Nutr. 2023;14(4):685–709. doi: 10.1016/j.advnut.2023.04.007.
Kohler LN, Garcia DO, Harris RB, et al. Adherence to diet and physical activity cancer prevention guidelines and cancer outcomes: A systematic review. Cancer Epidemiol Biomarkers Prev. 2016;25(7):1018–1028. doi: 10.1158/1055-9965.EPI-16-0121.