Taking place under the tagline ‘We can. I can.’, World Cancer Day 2016-2018 will explore how everyone – as a collective or as individuals – can do their part to reduce the global burden of cancer.
Just as cancer affects everyone in different ways, all people have the power to take various actions to reduce the impact that cancer has on individuals, families and communities.
World Cancer Day is a chance to reflect on what you can do, make a pledge and take action. Whatever you choose to do ‘We can. I can.’ make a difference to the fight against cancer.
WCD2016 website http://www.worldcancerday.org/ materials http://www.worldcancerday.org/materials and ways to help http://www.worldcancerday.org/get-involved
2. The first step in driving progress around
cancer is to push for actions that we
know will improve survival rates and
give cancer patients a better quality
of life.
The World Cancer Declaration represents
a consensus between public health and
cancer experts that sets out 9 targets for
an effective response to cancer and other
non-communicable diseases (NCDs) –
mainly cardiovascular diseases, chronic
respiratory diseases and diabetes1
. It is a
tool that can be used by cancer control
organisations, groups of advocates,
employers, the media and others to urge
governments to implement policies and
programmes that the cancer community
knows will be successful if they are
adequately resourced.
With the inclusion of NCDs in the
post-2015 agenda and the world’s
governments committed to ‘reduce
by one third premature mortality
from NCDs through prevention and
treatment, and promote mental health
and wellbeing’ as part of the Sustainable
Development Goals (SDGs), using the
World Cancer Declaration to frame
and strengthen advocacy efforts is
imperative2
. By working together around
common targets and each using our
spheres of influence, we can unite in
driving governments to take decisive
action around cancer, commit adequate
resources and embed cancer and other
NCDs within broader development
planning processes.
1. World Cancer Declaration. http://www.uicc.org/world-
cancer-declaration
2. Transforming our World: The 2030 agenda
for sustainable development. https://
sustainabledevelopment.un.org/post2015
INSPIRE ACTION,
TAKE ACTION
WE CAN
WE CAN ALL CALL ON
GOVERNMENTS TO STEP UP
THEIR RESPONSE TO CANCER BY
PUSHING FOR ACTIONS THAT WE
KNOW WILL REDUCE PREMATURE
DEATHS, AND IMPROVE QUALITY
OF LIFE AND CANCER SURVIVAL
RATES.
4. Changes in the way we live mean that
more and more people around the
world are exposed to cancer risk factors
like smoking, poor diet, and sedentary
lifestyles. Educating and informing
individuals and communities about
the links between lifestyle and cancer
risk is the first step in effective cancer
prevention.
Smoking is still the biggest cancer risk
factor. Tobacco use accounts for five
million deaths every year, or 22% of all
cancer deaths1,2
. Reducing the rates of
tobacco use will significantly decrease
the global burden of a large number of
cancers, including of the lung, oral cavity,
larynx, pharynx, oesophagus, pancreas,
bladder, kidney, cervix and stomach, and
acute myeloid leukaemia. Alcohol use
has also been linked to cancers of the
mouth, pharynx, larynx, oesophagus,
bowel, liver and breast3
.
The rising levels of obesity are of concern
in many countries around the world.
Overweight and obesity are strongly
linked with an increased risk of bowel,
breast, uterine, ovarian, pancreatic,
oesophagus, kidney, and gallbladder
cancers later in life4
. Yet, about a third
of common cancers can be prevented
through a healthy diet, maintaining a
healthy weight and being physically
active5
. Specifically, the World Cancer
Research Fund International estimates
that for the 13 most common cancers,
about 31% of cases in the United States
are preventable through a healthy diet,
being physically active and maintaining
a healthy weight. The estimates for other
countries are 32% for the UK, 25% for
Brazil and 24% for China6
.
1. WHO. (2012). Global Report: Mortality attributable to
tobacco 2012. Geneva: World Health Organization.
2. Tobacco Atlas 2015
3. WHO. (2011). Global status report on alcohol and health.
Geneva: World Health Organization
4. World Cancer Research Fund / American Institute for
Cancer Research. Continuous Update Project Report.
http://www.dietandcancerreport.org/cup/index.php.
5. World Cancer Research Fund International. Link between
lifestyle and cancer risk. http://www.wcrf.org/int/link-
between-lifestyle-cancer-risk
6. World Cancer Research Fund International. http://www.
wcrf.org/int/cancer-facts-figures/preventability-esti-
mates/cancer-preventability-estimates-diet-nutrition
and http://www.wcrf.org/int/policy/nourishing-frame-
work?utm_source=update&utm_medium=email&utm_
campaign=NOURISHINGJuly
PREVENT CANCERWE CAN
EQUIPPING INDIVIDUALS AND
COMMUNITIES WITH APPROPRIATE
AND ADEQUATE KNOWLEDGE OF THE
LINKS BETWEEN LIFESTYLE AND
CANCER CAN EMPOWER PEOPLE
TO ADOPT HEALTHY CHOICES.
INDIVIDUALS AND COMMUNITIES
NEED TO BE INFORMED THAT MORE
THAN A THIRD OF CANCERS ARE
PREVENTABLE THROUGH ADOPTING
HEALTHY BEHAVIOURS.
6. In many cultures and societies today, cancer
remains a taboo subject. People living with
cancer are often subject to stigma and
discrimination that may stop them admitting
they have cancer and from seeking care and
support. Even within communities where
cancer is discussed openly, people affected
by cancer can sometimes be discriminated
against and feel isolated from friends and
peers1
.
Specific efforts are required to
improve knowledge of cancer, counter
misinformation and reduce stigma among
all communities2, 3
. Supporting awareness
campaigns such as World Cancer Day
can be a powerful platform to challenge
negative beliefs, attitudes and behaviours
that perpetuate myths about cancer4
.
Workplaces, community groups, healthcare
providers and schools can all take actions
to improve communication about cancer,
shifting perceptions and strengthening
support for people affected by cancer. In
schools, for example, theatre can provide a
platform for children, parents, and teachers
to work together to improve communication
and remove stigma around the disease. Such
education programmes have been shown
to be successful in supporting the inclusion
of children with cancer into everyday life at
school5
.
Governments can also play a critical
role in providing accurate information
to communities around effective cancer
interventions. For instance, extensive
social mobilisation has been identified as
critical to the implementation of human
papillomavirus (HPV) vaccination programmes
in low- and middle- income countries as
part of comprehensive cervical cancer
prevention strategies. Providing appropriate
and adequate information to communities,
especially to avoid rumours and myths is a key
factor to achieving high vaccine coverage6
.
The media also have a particular role to
play around public education campaigns
by disseminating information and raising
population-level awareness of cancer control
to change attitudes and dispel common
myths.
1. LIVESTRONG. (2011). Cancer Stigma and Silence
Around the World: A LIVESTRONG Report . Austin:
LIVESTRONG.
2. http://www.livestrong.org/What-We-Do/Our-Actions/
Programs-Partnerships/Anti-Stigma-Campaign
3. Cancer Research UK http://scienceblog.
cancerresearchuk.org/2014/03/24/dont-believe-the-
hype-10-persistent-cancer-myths-debunked/
4. American Cancer Society http://www.cancer.org/
aboutus/howwehelpyou/rumors-myths-and-truths
5. dos Santos Gomez LA (2007). Removing the stigma of
cancer at school. Lancet Oncol. 8:682-4.
6. Watson-Jones D, Mugo N, Lees S, Mathai M, Vusha
S, Ndirangu G, et al. (2015) Access and Attitudes to
HPV Vaccination amongst Hard-To-Reach Populations
in Kenya. PLoS ONE 10: e0123701. doi:10.1371/journal.
pone.0123701
CHALLENGE
PERCEPTIONS
WE CAN
GOVERNMENTS, COMMUNITIES,
SCHOOLS, EMPLOYERS AND MEDIA
CAN CHALLENGE PERCEPTIONS ABOUT
CANCER AND DISPEL DAMAGING
MYTHS AND MISCONCEPTIONS SO
THAT ALL PEOPLE ARE EMPOWERED
TO ACCESS ACCURATE CANCER
INFORMATION AND QUALITY CANCER
PREVENTION AND CARE.
8. Schools and workplaces have important
roles to play in preventing cancer. Every
school can foster a culture of health by
providing nutritional meals and time
for recreation and sport, and putting
practical food and physical education
on the school curriculum1,2
.
Workplaces of all sizes can put in
place policies and programmes that
motivate employees to adopt healthier
behaviours. Measures such as creating
100% smoke-free workplaces and
providing information and access to
smoking cessation tools; providing
access to healthy food options;
promoting active transport to and from
work; and increasing movement in the
workplace for example, through use of
stairs, are all effective ways to support
a healthier workforce3-5
. Workplace
wellness programmes can also promote
early detection by using communication
channels to communicate about the
signs and symptoms of some cancers
and where appropriate, encourage
and support participation in screening
programmes for early diagnosis6
.
Workplaces can also put in place policies
to prevent occupational exposure to
cancer-causing agents, such as asbestos
and other workplace carcinogens7
.
1. Food Revolution Day. School Resources. http://www.
foodrevolutionday.com/schools/#DVCHyR8LzJQL3EIf.97
2. Kitchen Garden Foundation. Teaching Resources. http://
www.kitchengardenfoundation.org.au/free-resources/
teaching-resources
3. UICC, Bupa. (2014). Cancer – It’s everyone’s business.
http://www.iccp-portal.org/cancer-its-everyones-
business
4. UICC, Bupa (2014). Less Smoking, Better Business. http://
www.iccp-portal.org/less-smoking-better-business
5. Global Smokefree Partnership. Smokefree-in-a-box.
www.globalsmokefreepartnership.org
6. UICC, Bupa (2015). Tackling breast cancer in the
workplace. http://www.iccp-portal.org/tackling-breast-
cancer-workplace
7. International Labour Office. Safety in the Use of
Asbestos. http://www.ilo.org/wcmsp5/groups/
public/@ed_protect/@protrav/@safework/documents/
normativeinstrument/wcms_107843.pdf
CREATE HEALTHY
ENVIRONMENTS
WE CAN
SCHOOLS AND WORKPLACES
CAN BE ENCOURAGED TO
IMPLEMENT MEASURES
THAT WILL MOTIVATE AND
SUSTAIN HEALTHY HABITS
THROUGHOUT A PERSON’S
EVERYDAY LIFE.
10. Closing the gap in access to affordable,
quality cancer care is an imperative
for maximising outcomes and quality
of life for all people living with cancer,
including children and adolescents.
Access to effective, quality cancer
care should be embedded within a
country’s National Cancer Control Plan
(NCCP). NCCPs should cover access
to each of the critical components
of a multidisciplinary approach
encompassing supportive and palliative
care, high-quality cancer medicines and
effective cancer treatment modalities1,2
.
This includes radiotherapy, which is
recognised as an essential tool in the
cure and palliation of cancer and is
indicated in more than half of new cancer
patients3
. Additionally, resource-sensitive
clinical guidelines can be used to assist
with the planning and delivery of early
detection and treatment4,5
. Addressing
barriers to equitable access to quality
cancer services should include the
alleviation of cultural and structural
issues e.g. transportation, as well as
policies and programmes to improve the
availability of a skilled cancer workforce.
Of equal importance is to address
affordability of care to protect
individuals and families from financial
hardship as a consequence of out-
of-pocket expenses. The provision of
universal health coverage (UHC) and
other social protection measures can
play an important role in closing the
unacceptable gaps in access to cancer
services that occur in most low-resource
settings.
1. International Cancer Control Partnership. Cancer Plans.
http://www.iccp-portal.org/cancer-plans
2. Hogerzeil HV, Liberman J, Wirtz VJ, et al. (2013).
Promotion of access to essential medicines for non-
communicable diseases: practical implications of the UN
political declaration. Lancet , 381, 680-9.
3. Delaney G, Jacob S, Featherstone C, Barton M. (2005).
The role of radiotherapy in cancer treatment: estimating
optimal utilization from a review of evidence-based
clinical guidelines. Cancer 104, 1129-37.
4. WHO. (2013). WHO guidelines for screening and
treatment of precancerous lesions for cervical cancer
prevention. Geneva: World Health Organization.
5. Yip CH, Smith RA, Anderson BO, et al. (2008). Guideline
Implementation for Breast Healthcare in Low- and
Middle-Income Countries Early Detection Resource
Allocation. Cancer 113, 2244-56
IMPROVE ACCESS
TO CANCER CARE
WE CAN
WE CAN ADVOCATE FOR IMPROVED
ACCESS TO CANCER TREATMENT
AND SERVICES ACROSS THE CARE
CONTINUUM. ALL PEOPLE HAVE THE
RIGHT TO BENEFIT FROM THESE
INTERVENTIONS ON EQUAL TERMS,
REGARDLESS OF GEOGRAPHY AND
WITHOUT SUFFERING ECONOMIC
HARDSHIP AS A CONSEQUENCE.
12. Inadequate education of healthcare
providers is one of the most pervasive
and urgent obstacles to address in
delivering quality cancer care1
.
Investment in continuing professional
development (CPD) to equip healthcare
workers with the appropriate tools and
knowledge to deliver best practice
services across the cancer care
continuum is vital. This includes building
expertise and capacity amongst health
professionals to recognise the early
signs and symptoms of some cancers,
as well as appropriate early detection
measures; ensuring the safe and proper
administration of chemotherapy and
other cancer treatment modalities
including radiotherapy and surgery; and
delivering palliative care and pain and
distress management.
Whilst education can include both
conventional teaching methods as well
as e-learning platforms and multimedia
tools, where possible it should also build
on existing materials, training networks
and infrastructure2-4
.
1. Global Health Workforce Alliance. (2013). A universal
truth: no health without a workforce. Geneva: World
Health Organization.
2. C-Change. (2012). A National Strategy to Strengthen
the Cancer Workforce: Position Statement and Call to
Action. http://c-changetogether.org/Websites/cchange/
images/Workforce/WORKFORKCE_POSITION_
STATEMENT-_with_endorsements-_February_28_2013.
pdf
3. iheed Institute. (2012). Preparing the next generation of
community health workers: The power of technology
for training. iheed Institute, the Barr Foundation, the
mHealth Alliance, and the MDG Health Alliance. Cork,
Ireland: Dalberg Global Development Advisors.
4. The Recife Political Declaration on Human Resources for
Health (HRH). http://www.who.int/workforcealliance/
forum/2013/recife_declaration_13nov.pdf
BUILD A QUALITY
CANCER WORKFORCE
WE CAN
THE CANCER WORKFORCE
CAN BE EQUIPPED WITH THE
SKILLS, KNOWLEDGE AND
COMPETENCIES REQUIRED
TO MEET THE NEEDS OF
INDIVIDUALS AND COMMUNITIES
ACROSS THE CANCER
CONTINUUM.
14. Identifying and mobilising networks
to support efforts to reduce the global
cancer burden goals are critical to
strengthen advocacy efforts and
build capacity through education and
training1
.
For example, UICC as a founding
member of the NCD Alliance recognises
the power of working together as a
network united in the goal of creating
sustained global action on non-
communicable diseases (NCDs). Through
the NCD Alliance, local, national and
regional networks of cancer experts and
advocates have come together to drive
remarkable progress in elevating cancer
and other NCDs on the global health and
development agenda.
Other key global cancer networks, such
as the global coalition Cervical Cancer
Action, aim to maximise the impact of
those working to stop cervical cancer.
Through political mobilisation, the
coalition is increasing outreach activities
to expand global support to end cervical
cancer, engaging champions from
diverse constituencies—youth, cancer,
women’s issues, HIV/AIDS, sexual and
reproductive health and health policy—
to support a comprehensive approach to
cervical cancer prevention.
Building networks of experts can also
provide a platform for knowledge
exchange. For example, the McCabe
Centre for Law and Cancer builds
capacity in the use of law to prevent
and control cancer and other NCDs
particularly in the context of developing
coherence between health, trade and
investment laws, policies and sectors.
1. UICC Advocacy Toolkit 2014. http://www.uicc.org/
advocacy/advocacy-resources
2. NCD Alliance. http://www.ncdalliance.org/
3. Cervical Cancer Action. http://www.
cervicalcanceraction.org/home/home.php
4. McCabe Centre for Law and Cancer. Intensive legal
training program. http://www.mccabecentre.org/events/
intensivelegaltrainingprogram
MOBILISE OUR NETWORKS
TO DRIVE PROGRESS
WE CAN
THE GLOBAL CANCER COMMUNITY
CAN MOBILISE THEIR NETWORKS
TO REDUCE THE GLOBAL
CANCER BURDEN, TO PROMOTE
GREATER EQUITY, AND TO
INTEGRATE CANCER CONTROL
INTO THE WORLD HEALTH AND
DEVELOPMENT AGENDA.
16. The law and regulatory measures can
be used effectively to reduce exposure
to cancer risks including to tobacco,
alcohol and unhealthy foods, as well as
environmental exposures.
Tobacco taxation has been identified as the
single most important policy intervention that
governments can take to reduce major risk
factors for NCDs1
. It costs little to implement
and increases government revenues. The
World Health Organization (WHO) calculates
that if all countries increased taxes on
cigarette packs by 50%, there would be 49
million fewer smokers (38 million fewer adult
smokers and 11 million fewer young future
smokers) and this would avert 11 million
deaths from smoking2
. Additionally, policy
interventions around product labelling,
procurement and regulation of advertising,
promotion and sponsorship can reduce
exposure to unhealthy foods and drinks3,4
.
Effective policy at the national level can
also improve access to essential cancer
medicines including pain relief medicines,
and deliver quality cancer care. Following
a targeted advocacy campaign, in 2014 at
the World Health Assembly, governments
adopted a resolution which provided clear
recommendations to improve access to
palliative care5
. These include ensuring
palliative care is embedded in all national
health policies and budgets, and in the
curricula for health professionals. Vitally,
it also highlights the need for countries to
ensure that there is an adequate supply of all
essential palliative care medicines for adults
and children.
In another concerted advocacy effort, UICC
led a close collaboration with WHO and
a dedicated task team to ensure the best
representation of cancer drugs in the WHO
Model List of Essential Medicines (EML).
As a result of these efforts, in May 2015, the
latest edition of the WHO EML was published
and includes 16 new cancer treatments - a
milestone in patients’ access to cancer
medicines6,7
.
Patients, families, healthcare providers and
civil society now need to continue to advocate
to governments for the implementation of
policies and programmes at the national level
that translate these commitments into action
for patients and their families.
1. Jamison DT, Summers LH, Alleyne G, et al. (2013). Global
health 2035: a world converging within a generation.
Lancet, Published Online December 3, 2013 http://dx.doi.
org/10.1016/.
2. WHO (2014). Raising tax on tobacco: What you need to
know. Geneva: World Health Organization.
3. WHO. (2010). Set of recommendations on the marketing
of foods and non-alcoholic beverages to children.
Geneva: World Health Organization.
4. WCRF International. (2014). WCRF International Food
Policy Framework for Healthy Diets: NOURISHING.
http://www.wcrf.org/policy_public_affairs/nourishing_
framework/index.php.
5. WHO (2014). Strengthening of palliative care as a
component of integrated treatment throughout the life
course. A67/31 4 April 2014.
6. 19th
WHO Model List of Essential Medicines (April
2015). www.who.int/medicines/publications/
essentialmedicines/EML2015_8-May-15.pdf
7. 20th
WHO Expert Committee report on the Selection
and Use of Essential Medicines (2015) www.who.int/
medicines/publications/essentialmedicines/Executive-
Summary_EML-2015_7-May-15.pdf
SHAPE POLICY CHANGEWE CAN
EFFECTIVE ADVOCACY FOR POLICY CHANGE
AT ALL LEVELS - LOCAL, NATIONAL, AND
GLOBAL - CAN REDUCE EXPOSURE TO CANCER
RISK FACTORS AND IMPROVE ACCESS AND
AVAILABILITY OF ESSENTIAL CANCER MEDICINES
AND QUALITY CANCER CARE.
17. MAKE THE CASE FOR
INVESTING IN CANCER CONTROL
WE CAN
world
cancerday.org
WWW.WORLDCANCERDAY.ORG
ON 4 FEB
#WeCanICan
#WorldCancerDay
18. The economic case for investment is
becoming a vital piece of the jigsaw to
change mind-sets around the value of
investing in cancer prevention and control1
.
There is already a compelling argument for
investing in prevention of cancer rather than
dealing with the consequences. A case in
point is tobacco control. While the annual
economic costs of tobacco-attributable
cancers exceed USD 200 billion, for the
average low- and middle- income country
(LMIC), the amount necessary to deliver the
four “best buy” tobacco control measures is
approximately USD 0.11 per capita2,3
. The four
measures include: tobacco tax increases,
smoke-free policies, package warnings, and
advertising bans.
Of these four measures, increasing excise
taxes on tobacco products is widely accepted
as one of the most effective and affordable
tobacco control intervention4
. The World
Health Organization (WHO) estimates that
raising tobacco taxes costs as little as USD
0.005 per person per year and can save
millions of lives4
. Additionally, it has been
shown that raising tobacco taxes does not
lead to a fall in government revenues –
evidence suggests that if countries increased
tobacco tax by 50% per pack, governments
around the world would earn an extra USD 101
billion in revenue5
.
The cancer community is now drawing on
its networks of experts to build the global
evidence base on the economic costs and the
return on investment (ROI) in taking on other
proven strategies for cancer prevention, early
detection and health systems strengthening.
This includes the case for investment in
radiotherapy, an essential tool in the cure
and palliation of cancer that is indicated in
more than half of new cancer patients6
. The
Global Task Force on Radiotherapy for Cancer
Control (GTFRCC) has convened radiotherapy
professionals, industry partners, cancer
leaders, global health experts, economists,
and enablers of healthcare change, to quantify
the investment needed to provide equitable
access to radiation therapy worldwide7
.
1. UICC. The Economics of cancer prevention & control:
Data digest (2014). http://www.iccp-portal.org/
economics-cancer-prevention-control-data-digest
2. World Health Organization. Scaling up action against
noncommunicable diseases: how much will it cost?
Geneva : WHO Press; 2011
3. Tobacco Atlas. Investing in tobacco control. http://www.
tobaccoatlas.org/topic/investing-in-tobacco-control/
4. Chaloupka F, Yurekli A, Fong G. Tobacco Taxes as a
Tobacco Control Strategy. Tobacco Control. 2013.
5. World Health Organization. (2014). Raising tax on
tobacco - What you need to know, Geneva: WHO Press.
6. Delaney G, Jacob S, Featherstone C, Barton M. (2005).
The role of radiotherapy in cancer treatment: estimating
optimal utilization from a review of evidence-based
clinical guidelines. Cancer 104, 1129-37.
7. Global Task Force on Radiotherapy for Cancer Control
(2014). http://gtfrcc.org/
MAKE THE CASE FOR
INVESTING IN CANCER
CONTROL
WE CAN
BUILDING THE ECONOMIC CASE
FOR INVESTMENT IN CANCER CAN
CHANGE MIND-SETS AND ALLOW
GOVERNMENTS TO JUSTIFY PLACING
CANCER CONTROL AT THE HEART OF
THEIR NATIONAL HEALTH PLANS.
20. The global cancer burden can
be reduced through synergistic
partnerships between governments,
civil society and the private sector,
that leverage complementary skills,
competencies and spheres of influence
to accelerate progress on shared goals
and aspirations.
By joining forces, civil society
organisations, cancer patient advocacy
groups and other stakeholders can
bolster their advocacy efforts around
common issues by creating a united
voice for positive change. Collaborating
actively with partners in advocacy can
also significantly reduce duplication of
efforts and ensure the best use of scarce
resources, as well as increasing access to
policy and political decision-makers.
Promoting active participation in
partnerships can also assist with
building capacity through the exchange
of knowledge and skills. For example,
the International Cancer Control
Partnership (ICCP) launched its
web-based portal on cancer control
planning and capacity-building in
2013 (www.iccp-portal.org). The ICCP
Portal supports sharing of best practice
resources relevant to the development,
implementation and evaluation of
national cancer control plans via a unique
online platform. All in the convenience
of one place, the portal provides a
comprehensive and reliable source of
materials for policymakers and cancer
planners - the key audience for making
sustainable change at a national level.
WORK TOGETHER
FOR INCREASED IMPACT
WE CAN
WORKING IN PARTNERSHIP
AROUND PROVEN SOLUTIONS
FOR CANCER CAN ACHIEVE
GLOBAL IMPACT BY
STRENGTHENING ADVOCACY
AND BUILDING CAPACITY
AROUND COMMON GOALS.
22. Everyone can take steps to reduce
their risk of cancer by choosing healthy
options including quitting smoking,
keeping physically active and choosing
healthy food and drinks.
Tobacco use is the single largest
preventable cause of cancer globally.
Quitting smoking will have a major
positive impact on an individual’s health
and that of their families and friends. The
good news is that quitting at any age is
beneficial, increasing life expectancy and
improving quality of life1
.
Individuals can also reduce their risk of
many common cancers by maintaining
a healthy weight, and making physical
activity part of their everyday lives2, 3
.
Being overweight or obese increases
the risk of ten cancers - bowel, breast,
uterine, ovarian, pancreatic, oesophagus,
kidney, liver, advanced prostate and
gallbladder cancers4, 5
. Alcohol is also
strongly linked with an increased risk
of several cancers. Reducing alcohol
consumption decreases the risk of
cancers of the mouth, pharynx, larynx,
oesophagus, bowel, liver and breast6
.
Overall, more than a third of common
cancers could be prevented by a
healthy diet, being physically active and
maintaining a healthy body weight.
Reducing exposure to ultraviolet (UV)
radiation from the sun and other sources,
such as solariums, is also important to
reduce the risk of many skin cancers7
.
1. Jha P, Peto R. (2014). Global Effects of Smoking, of
Quitting, and of Taxing Tobacco. N Engl J Med. 370:60-
8.
2. World Cancer Research Fund International. Our
cancer prevention recommendations. http://www.
wcrf.org/int/research-we-fund/our-cancer-prevention-
recommendations
3. World Cancer Research Fund International. Link between
lifestyle and cancer risk. http://www.wcrf.org/int/link-
between-lifestyle-cancer-risk
4. World Cancer Research Fund International/American
Institute for Cancer Research. Continuous Update
Project.
http://www.wcrf.org/int/cancer-facts-figures/link-
between-lifestyle-cancer-risk/cancers-linked-greater-
body-fatness
5. World Cancer Research Fund International/American
Institute for Cancer Research. Continuous Update
Project Reports.
http://www.wcrf.org/int/research-we-fund/continuous-
update-project-findings-reports
6. WHO. (2011). Global status report on alcohol and health.
Geneva: World Health Organization.
7. SunSmart. UV and sun protection. http://www.sunsmart.
com.au/uv-sun-protection
MAKE HEALTHY
LIFESTYLE CHOICES
I CAN
EVERYONE CAN MAKE HEALTHY
LIFESTYLE CHOICES TO REDUCE
THEIR RISK OF CANCER.
24. Diagnosing cancer isn’t always easy – not all
cancers show early signs and symptoms and
other warning signs appear quite late when
the cancer is advanced.
However, for a number of cancers, increasing
awareness of signs and symptoms and the
importance of timely treatment has been shown
to improve survival from cancer. This is because
finding cancer early almost always makes it
easier to treat or even cure. In fact, recent
figures from the United Kingdom for example,
have found that for eight common cancers
- bladder, bowel, breast, cervical, womb,
malignant melanoma, ovarian and testicular
cancers - survival is three times higher when
cancer is diagnosed early1
.
Health professionals play a critical role in early
diagnosis. Being equipped with the knowledge
and skills to recognise the early warning signs
of some cancers, knowing when symptoms
need to be investigated and referring patients
promptly for tests, can contribute to increasing
the proportion of cancers that are found
early. For instance, clinical breast examination
(CBE) can be performed by trained healthcare
workers in low resource settings and has the
potential to detect cancers earlier, particularly
in areas where the majority of breast cancers
are diagnosed at an advanced stage 2,3
. For
childhood cancers, healthcare workers can
be educated to recognise the warning signs
and symptoms of paediatric cancer in order
to reduce the likelihood of misdiagnosis and
ensure prompt referral to specialist medical
care at an early stage of the disease4
.
Individuals can also be encouraged to know
what’s normal for their body and to recognise
any unusual or persistent changes5
. For
example, a person can become familiar with
the look of their skin so they can be aware of
any changes that might suggest a skin cancer,
such as recognising a spot that is growing and
changing in shape or size6
.
For some cancers, there is robust evidence to
support cancer screening. For example, visual
screening for oral cancer is effective in reducing
deaths from this type of cancer in users of
tobacco and/or alcohol in countries with high
incidence, most notably in South Asia 7,8
.
1. Cancer Research UK. Survival three times higher when
cancer is diagnosed early: po.st/PilTnn
2. El Saghir NS, Adebamowo CA, Anderson BO, et al.
(2011). Breast cancer management in low-resource
countries: consensus statement from the Breast Health
Global Initiative. The Breast 20, S3-S11.
3. Knowledge summaries of comprehensive breast cancer
control. http://www.iccp-portal.org/knowledge-
summaries-comprehensive-breast-cancer-control
4. Workman GM, Ribeiro RC, Rai SN, et al. (2007). Pediatric
cancer knowledge: assessment of knowledge of warning
signs and symptoms for pediatric cancer among Brazilian
community health workers. J Cancer Educ 22, 181-5.
5. Cancer Research UK. Key signs and symptoms of cancer.
http://www.cancerresearchuk.org/about-cancer/cancer-
symptoms#accordion_symptoms13
6. Cancer Council Australia. Skin Cancer Identification
poster. http://www.cancer.org.au/content/pdf/
Factsheets/MS%20214%20CCA%20MELANOMA%20
POSTER%20V4%20.pdf#_ga=1.144286962.678793188.1
438205862
7. Rajaraman P, Anderson BO, Basu P, et al. (2015).
Recommendations for screening and early detection of
common cancers in India. Lancet Oncol 16:e352-61.
8. Sankaranarayanan R, Ramadas K, Thara S et al. (2013).
Long term effect of visual screening on oral cancer
incidence and mortality in a randomized trial in Kerala,
India. Oral Oncol 49:314-21.
UNDERSTAND THAT EARLY
DETECTION SAVES LIVES
I CAN
HEALTHCARE PROFESSIONALS AND
INDIVIDUALS CAN BE INFORMED OF
THE VALUE OF EARLY DETECTION AND
THE IMPORTANCE OF SEEKING CARE TO
IMPROVE CANCER SURVIVAL.
26. Maintaining social support networks
and talking about cancer can be
important strategies for coping with the
social and emotional impact of cancer,
both in the short and long term.
This is true for both the person living
with cancer and their carer(s). Support
can come from many sources – partners,
friends, family, colleagues, healthcare
professionals and counsellors – with
some people choosing to join self-help
or support groups. Support groups
can provide a caring and supportive
environment for people living with
cancer to express their feelings and
reduce anxiety and fear1
.
Sometimes the people at work make up
another vital network of support. Talking
about cancer with colleagues as well as
keeping in touch with them during work
absences can have a positive impact on
recovery2
.
Cancer caregiving can also have an
enormous influence on both physical and
mental health. Carers – most commonly
partners, family members or friends -
receive little preparation, information
or support to carry out their vital role3
.
Many carers put their own needs and
feelings aside to focus on the person
with cancer, and as a consequence may
experience emotional distress and social
isolation4
. Recognising the challenges of
looking after someone with cancer and
seeking support can have wide-ranging
benefits for coping and quality of life5
.
1. Ussher J, Butow P, Wain G. et al. (2005). Research into
the Relationship Between Type of Organisation and
Effectiveness of Support Groups for People with Cancer
and their Carers. http://staging.cancercouncil.com.au/
wp-content/uploads/2011/02/Executive-Summary-for-
CSG-research-2005.pdf.
2. Macmillan Cancer Support. Work and Cancer.
http://www.macmillan.org.uk/Cancerinformation/
Livingwithandaftercancer/Workandcancer/
Workandcancer.aspx
3. Northouse LL, Katapodi M, Song L, et al. (2010).
Interventions with family caregivers of cancer patients:
meta-analysis of randomized trials. CA Cancer J Clin,
60, 317-339.
4. NBCF. (2013). So I Bit down on the Leather: Ending the
Silence. Sydney: National Breast Cancer Foundation
5. Looking after someone with cancer. http://be.macmillan.
org.uk/be/s-330-information-for-carers.aspx
ASK FOR SUPPORTI CAN
PEOPLE LIVING WITH CANCER
AND THEIR CAREGIVERS CAN
ASK FOR SUPPORT TO HELP
THEM COPE WITH CANCER.
28. Support from friends, families,
employers and colleagues can help a
person living with cancer better adjust
to the changes cancer brings to their
lives and improve their quality of life.
For some people, support may be needed
over many years after the initial diagnosis
as they continue to live with the physical
and emotional impacts of cancer even
when treatment is finished.
Family members, especially partners
can be a critical source of support for a
person living with cancer. Often, family
members take on the role of carer and
sometimes adjusting to this change in
roles can place strain on relationships1
.
Keeping the lines of communication
open and talking about feelings can be
important ways to help couples cope
with changing relationships and other
physical and emotional challenges of
cancer.
Friends can play a major role in providing
emotional, social and practical support.
Spending time with a person, being
willing to talk about their experiences
and providing assistance with errands or
tasks can all be enormously helpful2
.
At work, a supportive approach
from employers and colleagues can
reduce anxiety and provide the skills
and confidence to return to work
successfully. For employers, making
adjustments such as changes in tasks,
hours, or function and maintaining
open communication can be important
factors in getting people back to work
successfully. For colleagues, being
sensitive to the needs and feelings of the
person affected by cancer at work and
keeping in touch during time away from
the workplace can be very helpful. Some
workplaces have an employee assistance
programme or other type of support
network to help employees affected by
cancer or other illnesses3, 4
.
1. Girgis A, Lambert S, Johnson C, et al. (2013). Physical,
Psychosocial, Relationship, and Economic Burden of
Caring for People With Cancer: A Review. J Oncol
Practice, 9, 197-202
2. American Cancer Society. Be a friend to someone
with cancer. http://www.cancer.org/treatment/
understandingyourdiagnosis/talkingaboutcancer/how-
to-be-a-friend-to-someone-with-cancer
3. Macmillan Cancer Support. Work and Cancer. http://
www.macmillan.org.uk/information-and-support/
organising/work-and-cancer/if-youre-an-employer
4. American Cancer Society. When someone you
know has cancer. http://www.cancer.org/treatment/
understandingyourdiagnosis/talkingaboutcancer/
whensomeoneyouknowhascancer/when-someone-you-
know-has-cancer-toc
SUPPORT OTHERSI CAN
GIVING HOPE AND SUPPORT TO
SOMEONE LIVING WITH CANCER
CAN MAKE A BIG DIFFERENCE IN
THEIR LIFE.
30. Cancer patients and families should be
empowered to have a greater degree of
control over the choices that influence
their health and wellbeing and preserve
their dignity at all stages throughout the
cancer journey.
Many patients value having a voice in
their care, so it is important for cancer
specialists to agree on a treatment
plan that respects their expertise as
well as the patients’ individual needs
and preferences1
. Providing clear
explanations of the available options,
including the risks, benefits, and
uncertainty associated with the options
are all important to help patients play an
active role in decisions about their care
across the entire cancer journey2,3
.
Cancer patients receiving palliative or
supportive care may have particular
needs to get relief from symptoms,
pain, and distress4
. Having access to
person-centred, dignity-conserving care
where patients take part in decisions,
and all their care needs are addressed –
their physical, emotional, spiritual, and
social needs – is essential to delivering
effective palliative or supportive care5,6
.
1. Kehl KL, Landrum MB, Arora NK, et al. Association of
actual and preferred decision roles with patient-reported
quality of care: shared decision making in cancer care
[published online February 12, 2015]. JAMA Oncol.
doi:10.1001/jamaoncol.2014.112.
2. Politi MC, Studts JL, Hayslip JW. (2012). Shared Decision
Making in Oncology Practice: What Do Oncologists
Need to Know? Oncologist. 17:91-100
3. MacMillan Cancer Support. Making treatment decisions.
http://www.macmillan.org.uk/information-and-support/
treating/treatment-decisions
4. American Cancer Society. A Guide to Palliative or
Supportive Care. What is palliative care? http://www.
cancer.org/treatment/treatmentsandsideeffects/
palliativecare/supportive-care
5. Pringle J, Johnston B, Buchanan D. (2015). Dignity and
patient-centred care for people with palliative care
needs in the acute hospital setting: A systematic review.
Palliat Med. Mar 23. pii: 0269216315575681
6. WHO (2014). Strengthening of palliative care as a
component of integrated treatment throughout the life
course. A67/31 4 April 2014.
TAKE CONTROL OF
MY CANCER JOURNEY
I CAN
PEOPLE LIVING WITH CANCER
CAN TAKE CONTROL OF THEIR
CANCER JOURNEY BY BEING
EMPOWERED TO BE ACTIVE
PARTICIPANTS IN DECISIONS
ABOUT THEIR CARE, HAVING
THEIR CHOICES RESPECTED AND
THEIR NEEDS MET.
32. Cancer and its treatment can place strain
on relationships, with both the person
living with cancer and their partner facing
challenges around communication, intimacy
and sexual wellbeing.
Cancer touches everyone in a patient’s life in
a different way. Partners may be especially
affected and experience feelings of anger,
frustration and anxiety1-3
. They may also
be adjusting to changes in their role and
responsibilities as the primary caregiver, all
of which can lead to strain on a relationship.
While there is no ‘right way’ for a cancer
patient and their partner to cope with cancer,
there are things that couples can do to
support each other through this challenging
time1
. For example, keeping the lines of
communication open and taking time to talk
about feelings and difficult topics such as a
fear of recurrence or financial concerns can be
helpful in dealing with the emotional impacts4
.
Some couples may also benefit from talking
with a counsellor or others who have been
through their own cancer journey.
For many, one of the longest lasting, and
most devastating consequences of a cancer
diagnosis is the impact on sexual health
and wellbeing5
. Both men and women can
experience changes to sexual function and
sexuality after cancer treatment6
. For example,
men may experience physical changes to their
sexuality arising from nerve damage as a result
of some surgery or radiotherapy for prostate
cancer. Changes may be also be associated
with side effects of treatment such as fatigue,
pain and weight gain, which can contribute
to distress and negative emotional responses
and lead to feelings of sexual unattractiveness.
Seeking information and assistance from
health professionals and cancer support
services can help cancer patients to adjust to
changes in sexual function and help couples to
renegotiate sex and intimacy.
1. Macmillan Cancer Support. Relationships – You and your
Partner. http://www.macmillan.org.uk/information-and-
support/coping/relationships/you-and-your-partner
2. Girgis A, Lambert S, Johnson C, et al. (2013). Physical,
Psychosocial, Relationship, and Economic Burden of
Caring for People With Cancer: A Review. J Oncol
Practice, 9, 197-202
3. NBCF. Ending the silence for men whose partners
have breast cancer. http://www.nbcf.org.au/Research/
Research-Achievements/Partners-and-Breast-Cancer-
Report.aspx
4. Livestrong. Communicating with your partner. http://
www.livestrong.org/we-can-help/preparing-yourself/
communicating-with-your-partner/
5. Ussher JM, Perz J & Gilbert, E. (2012). Changes to sexual
well-being and intimacy after breast cancer. Cancer
nursing, 35, 456-65
6. Perz J, Ussher JM, Gilbert et al (2014). Feeling well and
talking about sex. BMC Cancer 14:228.
LOVE, AND BE LOVEDI CAN
WORKING TOGETHER THROUGH
THE CHALLENGES OF CANCER
AND ITS TREATMENT CAN
HELP PEOPLE LIVING WITH
CANCER AND THEIR PARTNERS
CONTINUE A CLOSE AND LOVING
RELATIONSHIP.
34. Cancer and its treatment can
change how people living with cancer
feel about themselves and the way
they look.
These feelings may come from the
physical changes that can occur during
and after treatment. Changes may
be short-term such as hair loss from
chemotherapy, or long-term changes
such as impairment to speech or loss of
a limb from surgery for some cancers,
all of which can diminish a person’s
quality of life and result in stigma and
discrimination1-3
. Even if others can’t
see these changes, for example urinary
incontinence sometimes arising from
prostate cancer treatment, they can have
an enormous impact on body image,
contributing to anxiety and depression.
For many cancer patients, addressing
issues of body image is an important
way of regaining control and preserving
a degree of normality. Accessing
dedicated support services to manage
their physical appearance such as
wearing a wig or prosthesis, can improve
self-esteem and quality of life4,5
. Seeking
counselling from a health professional
and keeping active with regular exercise
are other ways for cancer patients to
build confidence in the way they look
and feel about themselves6
.
1. Fingaret MC, Teo I, Epner DE. (2014). Managing body
image difficulties of adult cancer patients: Lessons from
available research. Cancer. 120:633–41.
2. Rosenberg SM, Tamimi RM, Gelber S et al. (2013). Body
image in recently diagnosed young women with early
breast cancer Psycho-Oncology. 22:1849-55.
3. Taylor-Ford M, Meyerowitz BE, D’Orazio, LM, et al.
(2013). Body image predicts quality of life in men with
prostate cancer. Psycho-Oncology 22, 756–761
4. National Cancer Institute. Self Image and Sexuality.
http://www.cancer.gov/about-cancer/coping/self-image
5. American Cancer Society. Prostheses. http://www.
cancer.org/treatment/treatmentsandsideeffects/
physicalsideeffects/dealingwithsymptomsathome/
caring-for-the-patient-with-cancer-at-home-prostheses
6. Macmillan Cancer Support. Changes to appearance and
body image. http://www.macmillan.org.uk/information-
and-support/coping/changes-to-appearance-and-body-
image/body-image-after-treatment
BE MYSELFI CAN
WITH THE RIGHT SUPPORT,
PEOPLE LIVING WITH CANCER
CAN FEEL LIKE THEMSELVES
AGAIN.
36. Although returning to work after cancer
treatment can be challenging for many
people, managing a smooth transition
back into the workplace can be a
significant factor both from a personal
and a practical standpoint. A job can
restore normality, routine, stability,
social contact and income1
.
Most often, people living with cancer
need their employers to make some
allowances to support them to get back
to work successfully. Talking about
cancer to their employers can help them
to make adjustments such as changes
in tasks or function, or supporting a
phased-return to work. People affected
by cancer can be encouraged to know
that when they return to work they are
likely to find a workplace environment
that is willing to help them adapt to the
challenges they face from their illness.
It is also important for people with
cancer who want to return to work
to understand their rights. In many
countries, employers have a legal
obligation to make reasonable
adjustments at work for people living
with cancer and to ensure they are not at
a disadvantage to other employees2
.
1. Macmillan Cancer Support. Work and Cancer.
http://www.macmillan.org.uk/Cancerinformation/
Livingwithandaftercancer/Workandcancer/
Workandcancer.aspx
2. McCabe Centre for Law & Cancer, Cancer Council
Victoria. (2013). Making the law work better for people
affected by cancer. Melbourne: McCabe Centre for Law
& Cancer.
RETURN TO WORKI CAN
WITH THE RIGHT SUPPORT,
PEOPLE LIVING WITH CANCER
CAN RETURN TO WORK
SUCCESSFULLY.
38. Cancer survivors can give hope to those
newly diagnosed with cancer.
By sharing their experiences, people
living with cancer can play an important
role in increasing knowledge about
cancer prevention and the importance
of early detection. Importantly, they can
also reduce fear around the challenges of
returning to everyday life after cancer.
Sharing stories through the media,
community networks and support groups
can raise awareness of the full impact of
cancer on both emotional and physical
wellbeing and be a powerful part of
advocacy efforts by showing policy
makers the heart and soul of an issue.
By telling their own stories, cancer
survivors can also help others by
breaking the silence around cancer
and reducing the fear and stigma that
often deter others from seeking care
and support1
. For example, the impact
assessment of an anti-stigma campaign
in Mexico that centred on giving cancer
survivors a platform to tell their own
stories, showed that 76% of people
exposed to the campaign learned
something new about cancer and 70%
said they now talk more openly about
cancer. Participants also commented
that they were more supportive of a
person with cancer because of what they
learned2
. We kindly encourage you to
share your story and experience with us
at worldcancerday.org/share-your-story
1. LIVESTRONG. (2011). Cancer Stigma and Silence
Around the World: A LIVESTRONG Report. Austin:
LIVESTRONG.
http://www.livestrong.org/What-We-Do/Our-Actions/
Programs-Partnerships/Anti-Stigma-Campaign
2. Results from LIVESTRONG Mexico anti-cancer stigma
campaign. http://blog.livestrong.org/2012/08/27/results-
from-livestrong-mexico-anti-cancer-stigma-campaign/
SHARE MY STORYI CAN
BY SHARING STORIES, CANCER
SURVIVORS CAN GIVE HOPE AND
SUPPORT TO OTHERS AFFECTED
BY THE DISEASE.
40. The participation of cancer patients
and their families in decision-making
around cancer policies and
programmes can foster a holistic
approach to cancer care.
Individuals can be part of the
conversation through engaging in
public campaigns, communicating
with decision-makers, and joining with
consumer support groups to ensure the
patient perspective is heard. In this way,
cancer patients and their families can
inspire change by helping to define the
issues that matter to them and advocate
for measures to address these1-3
.
Young people, for example, have a
particular role to play in shaping the
national and global response to cancer.
Through meaningful participation in
policy making processes as well as
grassroots advocacy, young people
can be advocates for cancer in their
communities, spreading knowledge
and shaping attitudes.
1. Cancer Voices Australia. http://www.
cancervoicesaustralia.org/
2. International Society of Paediatric Oncology. Childhood
Cancer Advocacy. http://siop-online.org/node/25
3. LIVESTRONG. (2011). Cancer Stigma and Silence
Around the World: A LIVESTRONG Report . Austin:
LIVESTRONG.
http://www.livestrong.org/What-We-Do/Our-
Actions/Programs-Partnerships/Anti-Stigma-
Campaign and http://media.marketwire.com/
attachments/201208/50210_SOW_MEXICO_ENGLISH_
FINAL.pdf
SPEAK OUTI CAN
BY BEING PART OF THE
CONVERSATION ABOUT CANCER,
INDIVIDUALS CAN BE POWERFUL
AGENTS OF INFLUENCE AND
CHANGE FOR ALL PEOPLE
AFFECTED BY CANCER.