Cancer Cancer is the second leading cause of death in this country. In 1999 alone it is estimated that 272,000 women will die from cancer. More than half of those deaths will be from lung, breast, and colorectal cancers. Our risk for cancer increases as we grow older. Take colorectal cancer, for example. One in 150 women ages 40 to 59 developed this type of cancer from 1993 to 1995. Raise the age to 60 to 79 years, and the ratio jumps to 1 in 32. "There's a very dramatic increase with age for most adult cancers," says Demetrius Albanes, M.D., senior investigator in the Cancer Prevention Studies Branch at the National Cancer Institute in Bethesda, Maryland. Scientists are not sure why cancer is largely an older person's disease, he says, but they theorize that it takes many years of exposure to a variety of carcinogens to eventually cause the genetic damage that results in cancer. And they think that the weakening of our internal defenses as we grow older may also play a part in the disease. There's at least one common type of cancer that is an exception to the aging rule and that's melanoma, a potentially deadly type of skin cancer. "Melanoma is actually a disease of young people," says Jessica Fewkes, M.D., assistant professor of dermatology at Harvard Medical School. "If you look at the largest group, the me¬ dian age is around 40." Whether you're 30, 40, or 60, you can take steps to lower your risk for any type of cancer. The most important thing you can do is obvious don't smoke. Lighting up is to blame for up to 90 percent of all lung cancer cases and lung cancer kills about 25,000 more women a year than breast cancer. If you do smoke, quitting now can dramatically lower your risk. Five years after kicking the habit, an ex smoker's risk of dying from lung cancer decreases by about half And after 10 smoke free years, the risk is similar to that of a nonsmoker. Keeping your weight within a healthy range and eating a diet that's low in dietary fat can also help lower your risk for lung, breast, and colon cancer, Dr. Albanes says. So can exercising regularly, he adds. In fact, a study of more than 1,800 women found that those who were moderately active had a 50 percent lower risk of breast cancer. Women who did more vigorous activity like swimming or running at least once a week were 80 percent less likely to develop breast cancer than inactive women. Whether or not cancer runs in your family, you can further cut your cancer risk with these preventive measures. Follow the five a day rule. When you sit down at your next meal, remember this catchy phrase: The food on your plate determines your fate. It may sound like a bit of a cliche, but research backs it up. An analysis of more than 200 studies shows that a diet high in agricultural produce cuts your cancer risk in half Consuming lots of fruits and vegetables can help prevent all three of the top cancer killers lung, breast, and colon cancer, Dr. Albanes says. Researchers don't think there's just one component in produce that protects against cancer, but rather a bunch of components such as the beta carotene found in sweet potatoes and carrots, the vitamin C in green peppers and citrus fruit, and phytonutrients like the isothiocyanates found in broccoli. To improve your chances of staying cancer free, aim for at least five fruits and vegetables a day. Go for fiber. Perhaps you've heard that fiber may not be as beneficial in warding off colon cancer as was once thought. That's based on the findings from a study of nearly 89,000 nurses who got most of their fiber from fruits and vegetables but ate very little of the wheat bran fiber that many other studies have found prevents colon cancer. More research is being done to confirm the benefits of fiber, but until then, keep in mind that even the authors of the study involving the nurses say it's very important to stick with a high fiber diet. How might fiber help prevent colon cancer? By causing stool to move more quickly through the body. That's important because the less time harmful compounds in the stool stay in the colon, the less likely they are to do damage. Eating a high fiber diet may also help cut your risk for breast cancer. That's because fiber routinely binds to estrogen in the digestive tract and removes it from the body, Dr. Albanes explains. The less estrogen women are exposed to over their lifetimes, the lower their risk of breast cancer. Pass up charred food. A survey of more than 900 women found that those who often ate well cooked meat such as hamburger, beefsteak, and bacon were nearly five times more likely to develop breast cancer than women who preferred their meat rare to medium. Researchers say that may have been a result of exposure to cancer causing compounds called heterocyclic amines, which form when meat and fish are cooked at high temperatures. You may be able to lower your risk of breast cancer by taking that steak off the grill before the black, crispy edges form. Take a multi. There's some evidence that higher intakes of the trace mineral selenium and several vitamins such as A and E, along with some carotenoids, like beta carotene may lower your risk for cancer, Dr. Albanes says. "We're also looking closely at dietary folate," he adds. And at least one study of 930 people suggests that taking extra calcium may help prevent colon cancer. While there isn't really strong evidence yet, it wouldn't hurt to take a multivitamin/mineral supplement every day. Wear sunscreen. Unless you work on a submarine, you're bound to spend some time in the sun. The best thing that you can do to protect your skin from the sun's harmful rays is to wear sunscreen. "I recommend sunscreen with an SPF (sun protection factor) of at least 15 and full UVB/UVA protection," Dr. Fewkes says. And if you're going to be outside for a while, you should reapply the sunscreen every 2 to 3 hours, she adds. Get tested. Cancer's a mysterious disease. You can do everything right from not smoking to eating a healthy diet and still find a lump that turns out to be malignant. Perhaps that's because the disease often has a genetic component especially when it comes to melanoma, breast cancer, and colon cancer. Since you can't lower your cancer risk 100 percent, it's important to undergo screenings that can detect a tumor be fore you even have symptomswhen the cancer is most curable. To help detect breast cancer in its earliest stages, women should have a yearly mammogram starting in their forties and should do self exams every month, according to the National Cancer Institute. They should also have a clinical breast exam as part of their annual gynecological checkup. Some doctors suggest women begin getting yearly mammograms at age 50, but research shows that women under age 50 whose breast cancer was found through mammography had a 90 percent chance of survival. That's compared to the 77 percent survival rate of women whose cancer was found during a clinical breast exam. To catch colorectal cancer which is highly curable when found early women over age 50 should have a fecal occult blood test at least every 2 years. An 18 year study by researchers at the University of Minnesota found that this simple test can lead to a 33 percent reduction in deaths when done every year. When the test was done every 2 years, the drop in deaths was 21 percent. To head off skin cancer, you should see a dermatologist for a fullbody screening every year if you're 41 or older and every 3 years if you're between the ages of 20 and 40. And you should also be on the lookout for any changes in your freckles and moles it turns out that about half of all melanomas are found by the patient. 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