prevention

Treatment is rarely the only cause of a second cancer, and in adults it is usually not the main one. Smoking is the clearest example: after chest radiotherapy for Hodgkin lymphoma, the risks from tobacco and from treatment appeared to multiply rather than add, which makes stopping smoking the largest single lever a survivor has over this particular risk.

Aminolevulinic acid is painted on sun-damaged skin and then activated with a lamp, destroying actinic keratoses before they can become skin cancer; in Europe the gel is also approved for superficial basal cell carcinoma.

Italian oncologist who led TAM-01, the trial that showed a low dose of tamoxifen halves recurrence after non-invasive breast cancer with fewer side effects than the standard dose.

Aspirin is not a cancer drug but sits in cancer care in two places: low doses prevent clots in polycythaemia vera and essential thrombocythaemia, and long-term use lowers colorectal cancer in people with Lynch syndrome, while a trial in the healthy elderly found no benefit and possible harm.

What people eat, drink, weigh and do affects who gets cancer, how treatment goes, and who relapses. Those questions are answerable, and the good studies answer them with the rigour of a drug trial.

Produced the evidence that made Israel the first country to offer BRCA testing to a whole population group, by measuring cancer risk in carriers found through healthy men rather than through cancer clinics.

The 2009 US law that finally gave the FDA power over tobacco products, the cause of roughly a third of cancer deaths, including authority to ban flavours, restrict marketing and set nicotine levels, though it may not ban cigarettes or nicotine outright.

Cervarix is a vaccine against HPV types 16 and 18, the two types that cause most cervical cancers, authorised in the EU in 2007 and the US in 2009 after the 18,000-woman PATRICIA trial showed near-complete protection against type-specific precancer. GSK withdrew it from the US in 2016, but it remains WHO-prequalified and used in national programmes, including single-dose schedules.

Gardasil was the first HPV vaccine, licensed in 2006 to prevent cervical and other genital cancers and genital warts. It has been replaced in most countries by the nine-type version, Gardasil 9.

The UK-led prevention trial that showed five years of tamoxifen keeps preventing breast cancer for at least twenty years, and the reason NICE tells the NHS to offer it to premenopausal women at high familial risk.

The trial that made anastrozole a prevention drug, halving breast cancer in postmenopausal women at high risk and, with a licence granted in 2023, putting a generic tablet on the NHS prevention pathway.

Epidemiologist who led IBIS-I and IBIS-II, proving tamoxifen and anastrozole prevent breast cancer in high-risk women.

The Newcastle geneticist whose CAPP2 trial showed that two years of aspirin cuts bowel cancer in people born with Lynch syndrome, a result that still shapes NHS advice.

Colombian epidemiologist whose IARC studies proved HPV causes cervical cancer and identified the types the vaccines target.

Epidemiologist who showed HPV vaccination has nearly eliminated cervical cancer in vaccinated English women and leads NHS-Galleri.

Every donor transplant includes drugs to stop the new immune system attacking the body. A randomised trial in 2023 changed the usual choice: cyclophosphamide after the transplant, with tacrolimus and mycophenolate, worked better than the older combination. Prevention is not free, because the same drugs hold back the response to infection.

Raloxifene (Evista) is an osteoporosis tablet that also lowers the chance of developing invasive breast cancer in postmenopausal women at higher risk, with fewer womb-cancer problems than tamoxifen.

SciRouter is a prevention-first longevity start-up founded by Ryan Bethencourt that sells plant-based daily supplements for people, dogs and cats, and frames cancer and age-related decline as engineering problems to be prevented rather than treated.

The prevention charity that campaigns on the one lever in skin cancer that is bigger than any drug: what the country does about ultraviolet exposure, and what it charges for sunscreen.

A prevention trial for the group who get these cancers worst: people on long-term immunosuppression, for whom squamous cell carcinoma is not an event but a recurring condition.

Since December 2019 it has been illegal across the United States to sell tobacco or vaping products to anyone under 21, a rule that started in one Massachusetts town and spread state by state, aimed at the years when most smokers start.