Want to reduce your cancer risk? Dr.Richard Babor has been investigating the most effective things we can do to avoid getting cancer.
TV surgeon Dr Richard Babor has researched cancer prevention and is packing all those pearls of wisdom he has discovered into his new TVNZ show How Not To Get Cancer. He talks to Jamie Morton
Here's a scary number.
Every day, an average 60 Kiwis – that's enough to fill a coach or a restaurant – hear a word they never wanted to come out of their doctor's lips.
Here's an even scarier number: more than a third of those 60 people potentially could have avoided cancer.
Dr Richard Babor, a surgeon best known for his TVNZ series The Big Ward, knows plenty about how a healthy, well-balanced diet and plenty of exercise can make us less likely to encounter New Zealand's number one killer.
But, until recently, even his lifestyle was what he called "a bit hit and miss".
"Like anyone, I love sugar, fat and carbs… I have a thing for croissant," he says.
"But having gone out into the world looking for answers I can definitely say that I have changed."
He eats less meat and more veges and olive oil.
He sleeps more, exercises at a moderate pace, and enjoys it more.
"I've discovered that I absolutely cannot give up my love of croissants, but that's ok," he says.
"I might add - I'm also happier. My well-being has increased enormously."
Babor is packing all those pearls of wisdom he's learned from medical research, and applied in his own life, into the next TVNZ show he's hosting: How Not To Get Cancer.
Cancer, a collection of diseases, killed nearly 10 million people worldwide last year, and remains the biggest cause of death here in New Zealand.
The Global Burden of Disease study - the most comprehensive analysis of cancer-related health outcomes and patterns ever conducted – has shown just how dismal rates are among Kiwis.
It put New Zealand's rate of new cancer cases per 100,000 people - age-adjusted and as at 2016 - at 542.8.
That was behind only Australia (at 743.8) and worse than the US (532.9), the Netherlands (477.3) and Luxembourg (455.4).
It also showed how New Zealand also stood out for having the world's worst rate of deaths from malignant skin melanoma, along with the worst rate of new cases of leukaemia.
Our rates of the former cancer was 6.6 per 100,000 people - around six times the global average - while rates of the latter were 20.3 per 100,000 people, or three times the global average.
As it stood, more than 23,000 Kiwis were being diagnosed every year.
And figures recently released by the Ministry of Health showed more than 9500 people died from cancer each year, representing 31 per cent of all deaths recorded in New Zealand.
The number of people affected by cancer was also expected to increase by 50 per cent by 2035.
"Cancer diagnosis are going up," said Babor, an Auckland-based general, gastrointestinal and bariatric surgeon who sees the end result in his clinical work each week.
"It's more than troubling, it's an epidemic."
It's also something that's touched Babor personally.
"When my mother got breast cancer it really rocked me. Here I was a surgeon - and yet helpless.
"This was the moment when I really started thinking about prevention, but it hit home when my father died of sarcoma - I've been on a cancer-preventing journey ever since."
He says the effects of cancer really do ripple out from the patient to affect family, friends and communities.
"Feeling this first hand and seeing it play out every week in my job strongly motivates me. This, combined with my personal experience is what ignited my drive to pursue the idea that prevention is better than cure."
To researchers, cancer has always been a confounding disease to untangle not just because of its sheer diversity, but the intricate and individualised nature of what it affects: our cells.
The body is made up of millions of them, all of which grow and are renewed in a controlled way that keeps us healthy.
It's when this control is lost that cells begin to multiply unchecked instead of just renewing themselves.
Babor says our ageing population is a big factor in rising rates, and adds that cancer is mostly bad luck.
Sometimes, those cells just stop behaving the way they should, despite decades of healthy living.
But a massive 40 per cent can be prevented through lifestyle changes.
"And that's huge. We're so terrified of cancer - and the fear comes from the unknown," he says.
"Prevention is empowering, because knowledge can help overcome that fear."
For all that we read and hear about cancer today, Babor couldn't recall it being discussed much while growing up in Naenae in Lower Hutt.
"I can't remember cancer being a big part of my childhood," he says.
"I took for granted that the adults in my life smoke and drank, that was normal."
His becoming a doctor turned out to be a happy accident.
"Naenae College was in a very poor area, yet I was lucky enough to be educated at a time when it didn't matter how much your parents earned," he says.
"I was good at maths and science - and I was encouraged by the school. That was enough to get me into medical school. Had I applied today, there's no way I would get it.
"Yet back then, I had the feeling that I wasn't quite sure why I had chosen medicine. But the deeper I got into study and then career the more interesting it became and the more I was drawn in.
"What keeps me going now is that I feel I have a responsibility to help, to make a difference. Maybe that's why I became a surgeon. I am a practical person, I like to be hands-on."
Today, he mostly operates on cancer patients, because they have a high priority, but also on people with obesity.
In the last few years, he says there's been a noticeable cross-over between his cancer patients and obesity patients.
"We now know that obesity is a major risk factor for cancer. In the coming years obesity will over-take smoking as the No 1 cause of cancer," he says.
"It's worrying because the population is getting bigger and bigger. There are many cancers for which obesity is a risk factor."
And those cancers are becoming more common.
While weight-loss surgery can reduce cancer risk, he says, we can't fix an entire population through surgery.
At a time where a quarter of Kiwis are considered clinically obese – and two million of us will fit the criteria as soon as 2035 – we need to change our food environment, and fast.
Babor argues that fat isn't just a personal problem, but a collective one.
"And being fat isn't your fault if you live in a world saturated with unhealthy food," he says.
"We all have a duty not to judge, but to take responsibility and push for policy change.
The food industry is in charge of our food environment. The government is not doing enough to change that.
"Smoking is an obvious one that still is not sorted yet. And in New Zealand society our relationships with things like alcohol and meat, as well as UV exposure need particular attention because their effects on cancer risk are strong and they are potentially so fixable."
Of course, there's also plenty of little things that we can do in our day to day lives that can nudge our health, and cancer risk in the right direction.
He says his series isn't just the instructional guide its name suggests, but a personal journey through the foreign land of prevention.
"I have to admit that cancer prevention is something I knew little about," he says.
"My job as a cancer surgeon is like the ambulance at the bottom of the cliff. I wanted to know the rest of the story. I took a sabbatical, and went out into the world to look for answers."
The four episodes focus on food, lifestyle, medicine and technology, and the environment.
"I met some incredible people preventing cancer, and some amazing doctors and scientists, here in New Zealand, and across the world.
"The show asks some of the world's most brilliant people How Not To Get Cancer. Their answers make for a pretty fascinating series."
He explores how ancient eating patterns could hold the key to cancer prevention and the efficacy of so-called "superfoods" like kale.
He also explains how meat, sugar and ultra-processed foods affect our cancer risk, the latest science around obesity, and the power of fasting.
"There's a lot of talk about diet, but not much action," he says.
"Beyond "5+ A Day" we're not really sure what we are supposed to be doing. The link between diet and cancer is well-established and if you don't smoke, diet is the single most modifiable factor.
"That's why it's so important we talk about it."
The show takes a fascinating look at the diets of people who live the longest for clues to avoiding cancer.
"I'd like to know how to live to 100. So we visited a place that's teeming with centenarians – and asked them how they did it."
He further examines the impact of sleep and stress; our relationship with our most popular vices; and what hope genetic engineering could offer for ultimate cancer prevention.
In the last episode, he delves into how the environment can influence our cancer risk, through our relationship with the sun, air pollution and chemicals – and whether an ancient way of life can unlock more secrets of cancer prevention.
"We need to do much better on our approach to diet, exercise, smoking, drinking, and sun exposure," he says.
"We have a small country that could produce most of its own food, we shouldn't be exposed to so much unhealthy food. We are obsessed with sport, yet we're moving less.
"We need to encourage sport and exercise for everyone. We have an amazing and modern medical system with access to all sorts of information, vaccines, interventions and preventative strategies that could have more of an impact. As individuals we really need to make the most of free screening."
But he adds this isn't just a challenge for New Zealand.
All industrialised countries are suffering higher rates of cancer – and some are now taking obesity more seriously, and slapping more restraints on the food industry, especially around sugar.
Other countries such as Australia are investing in skin cancer prevention.
"Some countries and societies place more value on health, communities, and how we all support one another and our environment than we do," he says.
"But there are lessons to be learned from the Japanese, the French, the Americans and the Greeks.
"These are some of the places we visit in How Not To Get Cancer."
He says the ultimate goal of the series isn't just to help us all reduce our risk of cancer, but also to demystify it a little.
"It doesn't have to be so scary. There are loads of takeaways in every episode. We look at coffee, alcohol, meat, mobile phones and even sex.
"We can all integrate simple changes into our daily lives. I was really surprised by what we found out, and deeply heartened. But everyone seems to pick up on something different.
"Cancer prevention is the opposite of the pain and suffering we associate with the disease. It's a good-news story, that's the big take-away for me."
• How Not To Get Cancer airs at 8.30pm Tuesday July 2 on TVNZ 1 or TVNZ.co.nz
1. Keep to a healthy weight—be as lean as possible, especially around your waist.
2. Be physically active as part of everyday life.
3. Avoid sugary drinks and processed sugary foods.
4. Eat a variety of vegetables, fruits, wholegrains and pulses, such as beans and lentils.
5. Limit the amount of red meat (beef, pork and lamb) you eat, and avoid processed meat, for example bacon and salami.
6. Limit alcoholic drinks to two for men and one for women a day or less.
7. Limit the amount of salty processed food that you eat.
8. Get as many nutrients and minerals from food rather than taking supplements (vitamin pills).
9. It is best to breastfeed your baby for the first six months then continue while offering new foods.
10. After cancer treatment, follow the tips above.
Source: Cancer Society of New Zealand.
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