Any recommendation made to reduce cancer occurrence should not be one which could lead to an increased risk of other diseases. The recommendations which comprise the revised European Code Against Cancer should, if followed, also lead to improvements in other aspects of general health. It is also important to recognise from the outset that each individual has choices to make about their lifestyle some of which could lead to a reduction in their risk of developing cancer. These choices, and the rationale underlying their recommendation, are presented below.

Certain cancers may be avoided and general health improved if you adopt a healthier lifestyle:

- Do not smoke; if you smoke, stop doing so. If you fail to stop, do not smoke in the presence of non-smokers 
- Avoid Obesity 
- Undertake some brisk, physical activity every day 
- Increase your daily intake and variety of vegetables and fruits: eat at least five servings daily. Limit your intake of foods containing fats from animal sources 
- If you drink alcohol, whether beer, wine or spirits, moderate your consumption to two drinks per day if you are a man and one drink per day if you are a woman 
- Care must be taken to avoid excessive sun exposure. It is specifically important to protect children and adolescents.
- For individuals who have a tendency to burn in the sun active protective measures must be taken throughout life 
- Apply strictly regulations aimed at preventing any exposure to known cancercausing substances. Follow all health and safety instructions on substances which may cause cancer. Follow advice of national radiation protection offices

There are public health programmes that could prevent cancers developing or increase the probability that a cancer may be cured:

- Women from 25 years of age should participate in cervical screening.This should be within programmes with quality control procedures in compliance with European Guidelines for Quality Assurance in Cervical Screening
- Women from 50 years of age should participate in breast screening. This should be within programmes with quality control procedures in compliance with European Union Guidelines for Quality Assurance in Mammography Screening 
- Men and women from 50 years of age should participate in colorectal screening. This should be within programmes with built-in quality assurance procedures 
- Participate in vaccination programmes against Hepatitis B Virus infection
 
This study was supported by the Europe Against Cancer programme of the European Community
http://www.cancercode.org/code.htm

 Facts about Childhood Cancer

    Please remember, when searching for information on the internet...    

    - that every child with cancer regardless of financial or social class, race or native origin deserves access to the best possible treatment and medical care,
    - results may include links to information related to adult cancers; these are often quite different to childhood cancers even though they may have identical or similar names,
    - results may include information intended for different audiences; for example information for ocologists often assumes a great deal of prior knowledge and specialist education,
    - the search term may include a word that is spelt differently in American and UK English (eg. Leukemia vs. Leukaemia, tumor vs. tumour),
    - the quality of information on the Internet is variable; users should be aware of source reliability issues.

    Parents are strongly advised to discuss their information requirements with their doctor, who knows their child's specific details.

                            Children with cancer need everyone's help!

http://uicc.org/fileadmin/about/global.pdf


Cancer is a disease that affects many people. Many people are frightened when they hear about cancer. This fear some times discourages people from becoming informed and doing what they can to help prevent cancer. Learning more about cancer is a way to cope with the fear of cancer.
Cancer is a group of many diseases that are due to abnormal functioning of the body cells. The human body is made up of billions of these tiny cells. These cells form all parts of the body, skin, bones, heart, lungs, and other organs. Normally, these cells reproduce themselves to support the growth and repair of the body parts.
When a cell begins reproducing or dividing without the normal order, pattern or purpose, we call this a tumor. A tumor may be benign (not cancerous) or malignant (cancerous). A benign tumor may grow larger, but it does not spread to other parts of the body. It may cause serious problems, a blockage or appear unusual, but it usually can be removed and does not grow back.
A malignant tumor is cancerous. The tumor invades nearby parts of the body. It can spread to other parts of the body forming new tumors (this is called metastasis). In a malignant tumor, the cells are growing completely out of control.
In some cases, even when the original tumor is removed by surgery, the disease may continue to grow where it began or in other parts of the body if cancer cells already have spread.

Cancer occurs when there are changes in the part of the cell that controls reproduction or division of the cell. These changes can be caused by infection, like Hepatitis B, or by exposure to smoking. Scientists agree that people develop certain cancers through repeated or long term contact with one or more cancer causing substances called carcinogens. Carcinogens cause body cells to grow abnormally. Examples of carcinogens include some pesticides, radiation, chemical toxins, and tar in cigarettes. In addition, smoking cigarettes too much may cause
you to have lung, throat or bladder cancer. For some cancers, such as colon, prostate, breast or brain the causes are not clear, and we do not know why patients with these types of cancer get the disease when other people do not.
Treatment of hepatitis (liver disease), avoiding sunburns, or quitting smoking will reduce the chance of getting cancer from these causes. Early testing (screening) to look for cancer early (when it is small and has not spread to other parts of the body) can allow for treatments which will cure the cancer, preventing death from cancer.
Some of the infections that may cause cancer can be contagious, but cancer itself is not contagious. You won’t get cancer by being around someone who has cancer.
Some types of cancer, like breast or colon cancers, run in the family. The risk of getting these types of cancer may be higher for you if other relatives in your family had that type of cancer before. You can help yourself by getting tested early for the types of cancers that are common in your family.

Warning signs of cancer include:
 -  Losing a lot of weight without trying
 -  A cough that won’t go away and that is not TB
 -  Coughing blood, vomiting blood, or passing blood in the stool
 -  Blood coming from the vagina that is not menstruation
 -  Unusual changes in moles or skin
 -  Skin wound that will not heal
 -  Feeling very tired and weak without reason
 -  Lumps or growths
 -  Unexplained pain

Having these warning signs does not mean you have cancer. The signs may be caused by other things. If you have one or more of these signs, check with a doctor to know why.

Preventive health care and cancer treatment – Doing things to keep healthy Preventive health care is very important. It is necessary to eat the right foods, exercise and pay attention to your body if you want to be healthy. It is also very important for you to see your doctor as soon as you find any of the cancer warning signs, or any other health problems. Your doctor may recommend a test to find
cancer early before you have warning signs and, when a cancer is easier to cure.
Your doctor may find that you do not have cancer, but finding the disease at an early stage improves the chances of cure or control.
There are many different kinds of cancer. Some cancers are easier to treat than others. The treatment of cancer is improving. Old cancer treatments caused lots of side effects and were very difficult for patients. Now, there are many new and more effective cancer treatments. If cancer is found early, doctors can use these new treatments which are less troublesome and easier for patients. If cancer is
found early, doctors have a better chance of successfully curing the cancer.
Having cancer does not mean that you are fated to die from cancer, or that it is God’s will that you die from cancer. People who have cancer can often be cured, so that they do not die from cancer. If you have cancer, do not give up. It is important to seek treatment because most cancers can be treated.
If you have questions about the information you see here, or if you want to learn more about cancer and early testing, contact your family doctor for an appointment. If you believe you may have some unusual signs and believe they represent early signs of cancer, you should make an appointment with your doctor.

Adapted from the American Cancer Society pamphlet: WHAT YOU NEED TO KNOW ABOUT CANCER by Harborview Medical Center, AANCART and House Calls programs. Translation made possible by The Accessing Health
Information Project, funded by the National Library of Medicine.



Thousands of people a year could be saved from developing bowel (colon) cancer - if only they knew how.

Here are our Top Ten Tips - they won’t help everyone but will save many lives:

1. The wonders of walking - especially brisk walking. Daily walks (at least 30 minutes) boost the immune system, make our insides work more efficiently and help keep down fatty cells around our middle as we get older - these cells increase insulin which can encourage cancers to develop around the body.

2. You are what you eat - cut back on red meat, processed and fatty foods, step up wholemeal bread/pasta, oily fish, fruit and veg and you’ll really improve your chances of avoiding bowel cancer.

3. Older & wiser - most people who get bowel cancer are over 50 so the older you are, the more aware you need to be. Screening is the best way to catch it early. From April 2006 the over 60s will be offered free bowel cancer screening - it’ll be wise to accept

4. Weight watchers win - being fat increases your risk. Even if you’re fit and fat, you’re still at increased risk of bowel cancer. Big breakfast, middle sized lunch, small dinner, only fruit as snacks between meals - with exercise, it’s the best way to lose weight

5. Ask your granny - if there is any bowel cancer or other cancers in your family. Having close relatives affected can dramatically increase your risk - click on Family History to find out more

6 Know your onions - veg from the allium family (onion, garlic, leeks ..) are thought to protect the gut against cancer and it’s good advice to eat lots. Latest research looks good for watercress and broccoli too.

7 Think alternatives to aspirin - research shows aspirin can stop early cancers developing but get your doctor’s advice before you take it. A great alternative - organic green veg: they develop natural aspirin (salicylic acid) to help fight off plant diseases

8. Smoking & drinking - no surprise that smoking and heavy drinking, especially beer & spirits, can increase your chances of getting bowel cancer. To stop smoking, try the Quitline 0800 002200. Exercise helps to cut cravings; serious drinkers, contact www.al-anonuk.org.uk - serious smokers Quitline 0800 002200

9. Listen to your insides - ulcerative colitis, Crohn’s disease, inflammatory bowel disease, a history of polyps - bowel problems like these can lead to bowel cancer, especially if you developed them young or have had them a long time. Make sure your GP gets you monitored

10. Don’t sit on symptoms - millions of us have bleeding from the bottom and changes in our bowel movements every year. Get to know which are important and how to test them to see if serious before going to your GP - ring our 24-hour recorded symptoms hotline - 0870 24 24 870 or get our Step by Step guide, free from Lynn’s Bowel Cancer Campaign, address below. Pick up symptoms earlier and you might live longer.

“Bowel cancer is the commonest cancer in Europe and the second highest cancer killer in the UK, affecting one in 10 families. I want people to know that although being told you have cancer can be absolutely terrifying, it is not necessarily a death sentence. “This certainly applies to bowel cancer as it is one of the most treatable, curable and beatable cancers. Be aware of the symptoms and don’t be embarrassed about speaking to your GP. Being able to spot important symptoms might save your life.”
Margaret McMahon
http://www.bowelcancer.tv/cgi-bin/page.pl?page=HowToPrevent&accessability=no


PATIENTS' RIGHTS

1.  Every sick child and adolescent has the right to tuition within hospital or at home.
2. The aim of tuition for sick children and adolescents is the continuation of education, enabling them to maintain their pupil-role.
3. The hospital school creates a community of children and adolescents, and normalizes everyday life. Hospital education shall be organized as class, group or individual teaching and at the bedside.
4. Hospital and home tuition must be adapted to the needs and abilities of the child or adolescent in co-operation with the home school.
5. The learning environment and facilities must be adapted to the needs of sick children and adolescents, and communication technologies shall also be used to prevent isolation.
6. A variety of teaching methods and resources shall be used. The content encompasses more than formal curriculum learning. It includes subjects related to special needs arising from illness and hospitalization.
7. The hospital and home tuition teachers must be fully qualified and receive further training.
8. The teachers of sick children and adolescents are full members of the multi-disciplinary caring team and are the link between the hospitalized child or adolescent and the home school.
9. Parents must be informed about the right to schooling and the educational program of their sick child or adolescent. They shall be recognized as active and responsible partners.
10. The integrity of the child or adolescent shall be respected including medical confidentiality and private convictions.

Adopted by the General Assembly of HOPE
Barcelona - 20th May 2000
web: http://www.hospitalteachers.eu




Everyone has a right to expect quality care while in hospital. Hospital staff and parents have a special duty of care to children and a legal responsibility to protect the child’s rights, interests and wishes.
This is dependent on their age, understanding and the treatment they are having (this may differ in Scotland).
While in hospital:
A child can expect…

• to receive treatment on the basis of clinical need.
• courtesy and respect for privacy and dignity.
• treatment in a children’s hospital, unit or ward that is right for their age and medical condition, with play and education available.
• nursing care by appropriately trained children’s nurses.
• to be involved in discussions (if they are able to understand) and consideration to be given to their wishes.
• an introduction to the staff caring for them.
• their operation to be carried out by, or under the supervision of, a surgeon with appropriate training and experience in the care of children.
• anaesthetic from an anaesthetist who is trained and experienced in the care of children.

As the parent or guardian of a child you can expect…

• to be with your child during treatment, unless it puts either of you at risk, and to stay overnight if you wish.
• to choose to have a relative or friend with you during consultations and examinations.
• to be given time to ask questions about your child’s medical problems and suggested treatment and to get clear information about them (ask if written information is available).
• to be given a name and telephone number of someone you can ring if you have any other questions.
• to take part in all decisions about treatment and aftercare and to have the pros and cons, including any risks, side effects and alternative methods of treatment fully explained to you.
• to be informed day or night of any worsening in your child’s condition.
• staff to understand you may be feeling worried or nervous and this may affect the way you or your child behave.
• to be told if there is a delay when you arrive for an appointment, how long you may have to wait and why.
• to know the names, jobs and professional status of the staff involved in your child’s care.
• to have all details about you and your child treated in confi dence (except where required by law) and for your permission to be obtained before any details can be shared with anyone else.
• to have the right to see any information kept about your child and family.
• to complain if you are unhappy with the treatment you or your child receives.
• to be given an explanation and, where appropriate, an apology, if things do not go as planned.
• to choose whether or not your child may be seen by medical students.

You and your child have a responsibility…

• to treat all staff, other patients and families with courtesy and respect.
• to let the hospitals know at once if you change your address or telephone number.
• to understand that there are pressures of time and resources on the NHS and those working within it.
• to give staff full information about your child’s condition and to let the staff know if your child has any physical or learning disabilities, allergies, sensitivities, conditions or changes in their health and of any medicines they are taking, including over the counter remedies.
• to tell staff if your child is being, or has been, treated by other health care professionals that might be relevant to present treatment.
• to tell staff if you do not understand or are uncertain about any part of the diagnosis or treatment and ask for more information or clearer explanation (in writing if it helps).
• to follow the instructions given to you on the care of your child before going into hospital for an operation.
• to make sure that your child follows the advice on what to do after the operation (eg exercise, diet, etc); takes any medicine as instructed; and seeks medical advice before stopping or changing treatment.
• to think about and be aware of what might happen if you or your child refuse the
recommended treatment or do not follow the doctors’ advice and accept responsibility for those actions and the subsequent results for your child.
• to ensure that your child attends follow-up appointments and that all appointments are attended on time or that cancellation (with reasonable notice) is arranged.
• to make sure you, your child and all accompanying visitors follow all the hospital and ward rules.

JANUARY 2003
©The Patient Liaison Group at The Royal College of Surgeons of England.
Contact the PLG on tel: 020 7869 6045; fax: 020 7869 6045; or see the website at www.rcseng.ac.uk/welcome/information_for_patients_liaison/

Young people aged 16 or over but under 18 can give independent consent to their own treatment. It is not necessary to obtain the consent of a parent or guardian. A young person can be overruled by a court order.
However, if the young person is incapable of giving their own consent, for example, they are severely disabled, the parent’s or guardian’s consent must be obtained.
Children under 16 can give their own consent to treatment provided they are judged capable by a doctor, Primary Care Trust or NHS Trust, of understanding what is involved. There is no general test for assessing this capacity, and each case will be decided on its own merits.
If a child under 16 does not have sufficient understanding, parental consent (or a court order) will be required for any treatment, except in an emergency. If a child under 16 who does have sufficient understanding refuses treatment, treatment can still be given with their parent’s or guardian’s consent or by a court order.
Young people or children under 18 cannot give their own consent to experimental operations and blood donations, unless they have sufficient understanding of what is involved.
Scotland
In Scotland, a child under 16 can consent to, or refuse, any treatment if the qualified medical practitioner attending them believes they are capable of understanding the nature and possible consequences of the treatment. Parental consent should be obtained where a child under 16 does not have sufficient understanding, except in an emergency where there is not time to obtain it. If the local authority holds parental responsibility for a child under 16, consent from a parent or guardian does not need to be sought.
Northern Ireland
In Northern Ireland, a parent's consent may be required for any medical treatment for a young person aged under 16. However, in practice, if the young person understands the implications of the treatment involved, they can consent to, or refuse, medical treatment themselves.
A young person over 16, if competent, can give their own consent to treatment, although most hospitals will require parental permission to perform an operation on a young person under 18.

You refuse treatment for your child
If you, a guardian or child refuse to give consent for treatment which a doctor thinks is necessary, the doctor is still obliged to treat the child. The action the doctor takes will depend on how urgently the treatment is needed.
When a child’s life is in danger, the doctor has the right to do whatever is needed to save the child’s life. If you or a guardian either fail to provide medical help for a child, or unreasonably refuse to allow treatment, you can be prosecuted for neglect.
Children
There may be a number of issues which you may wish to consider if your child is to go into hospital, for example, whether you can stay with your child, how much help you can give with feeding and looking after your child and what will happen to your child’s education. Action for Sick Children may be able to advise on all these issues. It also produces a leaflet for parents whose child is going into hospital for the first time.

DIET reccomendations


According to the American Institute for Cancer Research (AICR), the world's most comprehensive cancer study being conducted in establishing the link between diet and cancer risk has been going on for over a decade and few people hear about it. Over 80 scientific papers based on the study have been published in journals such as the Journal of the National Cancer Institute, the Lancet, the Journal of Nutrition.

The study -- called the European Prospective Investigation into Cancer and Nutrition (EPIC) -- is an enormous undertaking involving 521,483 individuals in 10 different European countries. EPIC is unique because the populations being tracked are so diverse in eating habits. But this is precisely what gives the study the advantage it has in making comparisons and noting trends.

According to EPIC, a few of the emerging results found in the link between diet and cancer are:

Consumption of meat sharply increased risk of stomach cancer and esophageal cancer. For every 100 grams of meat consumed by subjects, risk for stomach cancer more than tripled. The association between meat intake and stomach cancer was considerably stronger among subjects with populations of H. pylori bacteria in their stomachs.
Two indicators of abdominal obesity, waist circumference and waist-to-hip ratio, were strongly associated with colon cancer risk in both sexes. Men with the largest waist circumference had 39 percent higher risk of colon cancer than men with the smallest, for example, while women in the study with the largest waist circumference has a 48 percent higher risk than women with the smallest waists.
Blood samples of women with breast cancer were compared to blood samples of women without breast cancer. Women over 60 whose blood was given under non-fasting conditions, high levels of serum C-peptide, that could reflect insulin resistance -- long suspected of contributing to cancer risk -- was associated with a doubling of breast cancer risk.
The risk for oral and pharyngeal cancers drop by 9 percent for every 80 grams of fruits and vegetables consumed per day.

Researchers are beginning to come to some conclusions involving the data they have to date that clearly shows that globally, diets that are high in fruits, vegetables, fiber and fish are associated with greater cancer prevention -- with obesity and sedentary lifestyles much larger factors in increasing cancer risk.

         
     The European Prospective Investigation into Cancer and Nutrition (EPIC) is coordinated by Dr Elio Riboli, Chief of the Nutrition and Hormones Group at the International Agency for Research on Cancer (IARC, which is part of the World Health Organization) in Lyon, France. EPIC received substantial financial support from the Europe Against Cancer Program of the European Commission.
      
    EPIC was designed to investigate the relationships between diet, nutritional status, lifestyle and environmental factors and the incidence of cancer and other chronic diseases. EPIC is the largest study of diet and health ever undertaken, having recruited over half a million (520,000) people in ten European countries: Denmark, France, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden and the United Kingdom (select a country from the map).
    Within these countries EPIC research scientists are based in 23 centres: one in France (Paris), Greece (Athens) and Norway (Tromsø), two in Denmark (Aarhus and Copenhagen), Germany (Heidelberg and Potsdam), Sweden (Malmo and Umea), the Netherlands (Bilthoven and Utrecht) and the United Kingdom (Cambridge and Oxford), five in Italy (Florence, Milan, Naples, Ragusa and Turin) and Spain (Granada, Murcia, Asturias, Pamplona, and San Sebastian with Barcelona the co-ordination centre). Originally there were 7 countries involved but between 1995 and 2000 Sweden, Denmark and Norway, which were already involved in similar studies, joined EPIC and thus broadened the European cohort to include Scandinavian populations.
 Recruitment into the study, which was initiated in 1992, was principally from the general population aged 20 years or over, and took place between 1993 and 1999. Detailed information on diet and lifestyle was obtained by questionnaire, and anthropometric measurements and blood samples were taken at recruitment. The blood is stored in liquid nitrogen for future analyses. By studying very many people in different countries with differing diets, using carefully designed and tested questionnaires, EPIC should produce much more specific information about the effect of diet on long-term health than any previous study. The first results were presented in June 2001 at the European Conference on Nutrition and Cancer and the conference proceedings have been published in Riboli E., Lambert A. (eds) : Nutrition and lifestyle : Opportunities for Cancer Prevention. IARC Sci. Publ. No.156. 2002.

It is planned to follow-up the study participants for the next 10 years at least, continuing to study the role of nutrition and lifestyle in cancer development and other chronic diseases. The EPIC Newsletter can be found here.

In September 2001 the 5 A Day Initiative project, under the auspices of the German Cancer Society in Frankfurt, Germany entered into a collaborative research agreement with the EPIC study.
 http://www.iarc.fr/epic/Sup-default.html


The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a Europe-wide prospective cohort study of the relationships between diet and cancer, as well as other chronic diseases, such as cardiovascular disease. With over half a million participants, it is the largest study of diet and disease to be undertaken.

EPIC is coordinated by the International Agency for Research on Cancer (IARC), part of the World Health Organization, and funded by the 'Europe Against Cancer' programme of the European Commission as well as multiple nation-specific grants and charities.

521,457 healthy adults, mostly aged 35-70 years, were enrolled in 23 centres in ten European countries: Denmark (11%), France (14%), Germany (10%), Greece (5%), Italy (9%), The Netherlands (8%), Norway (7%), Spain (8%), Sweden (10%) and the United Kingdom (17%). One UK centre (Oxford) recruited 27,000 vegetarians and vegans; this subgroup forms the largest study of this dietary group. Recruitment to the study took place between 1993 and 1999, and follow up is planned for at least ten years, with repeat interview/questionnaires every three to five years. The main prospective data collected are standardised dietary questionnaires (self administered or interview based), seven-day food diaries, blood samples and anthropometric measurements, such as body mass index and waist-to-hip ratio. Additionally, the GenAir case-control study is studying the relationship of passive smoking and air pollution with cancers and respiratory diseases.

Up to 2004, there were over 26,000 new cases of cancer recorded among participants, with the most common being cancers of the breast, colorectum, prostate and lung. Current analyses are focusing particularly on stomach, colorectal, breast, prostate and lung cancers. The different dietary patterns in the different countries should enable reliable associations to be made between particular diets and cancers. The analysis of stored blood samples should also allow dissection of genetic factors involved in cancers, as well as the effects of hormones and hormone-like factors.

Consumption of fibre, fish, milk and cheese reduce risk of colorectal cancer, while red and processed meat increase risk
Consumption of fruit and vegetables does not affect risk of breast or prostate cancer

Meat, Fish, and Colorectal Cancer Risk: The European Prospective Investigation into Cancer and Nutrition
http://jnci.oxfordjournals.org/cgi/content/full/97/12/906

Recommandations from BRISTOL CANCER HELP CENTRE, got for Association P.A.V.E.L., by: Dr. Luiza Dihoru, Dept. of Civil Engineering, University of Bristol
19 Martie 2006

USEFUL LINKS

Right to Health       

* CESCR General Comment No.14 on the Right to Health
    http://www.ohchr.org/english/bodies/cescr/comments.htm

* UN Special Rapporteur on the Right to Health, Paul Hunt
   http://www.ohchr.org/english/issues/health/right/index.htm

* The Right to Health: A Resource Manual for NGOs; By: Judith Asher
    http://www.huridocs.org/poprthea.htm

* The Right to Health as a Human Right in International Law; Brigit Toebes, School of Human Rights Research Series, Volume 1, Hart Intersentia, Antwerpen- Groningen-Oxford, 1999

* The ‘Right to Health’ in European Union Law, in: Economic and Social Rigths under the EU Charter of Fundamental Rigths, Hervey and Kenner eds., Hart Publishing, Oxford-Portland Oregon, 2003

* International Federation of Health and Human Rights Organisations
    http://www.ifhhro.org