Getting the best bang for your cancer prevention buck

The new year is here and nipping at its heels are those holiday bills, skyrocketing health insurance premiums and, of course, first-of-the-year resolutions to live your healthiest life ever. But how do you get healthy without busting your budget?

Gym memberships can be pricey and those influencer-touted supplements — most of which are understudied and none of which are regulated — can add up fast. Meanwhile, celebrities are GLP-1ing their way to gauntness and quelling their health anxieties with whole-body MRIs, spendy trends most people simply can’t afford.

Luckily, the disease-fighting experts at Fred Hutch Cancer Center know good health doesn’t require truckloads of money. Sometimes, less is more — unless you’re talking about sleep, of course!

Uncertain about how you can stay healthy on a tight budget, especially when bombarded with breathless misinformation from social media influencers and bad actors intent on separating you from evidence-based health info — not to mention your hard-earned dollars? Check out these budget-friendly health tips from Fred Hutch researchers and providers.

Regular exercise is medicine

Exercise truly is medicine when it comes to preventing disease, making it another top recommendation. Research shows it helps to prevent weight gain, a common disease driver, and it’s also a major cancer buster. Regular moderate physical activity lowers insulin, decreases inflammation and reduces excess estrogen levels, fuel for estrogen-receptor positive cancers. It also helps to repair DNA damage, another prime cancer driver. Exercise can also help you maintain a steady weight. Weight cycling or fluctuating up and down the scale — is bad for your immune system — and your overall health.

Exercise is so beneficial that the current chief medical officer for the Association of Clinical Oncology (ASCO), Julie Gralow, MD, (formerly at Fred Hutch) said she would package it into a pill if she could.

“If we could write a prescription for exercise, if we could bottle it in a pill, we’d be prescribing it for all of you,” she said. “Physical activity can reduce death from breast cancer by about 40% in early-stage patients. It has the most powerful effect of any lifestyle factor.”

Moving your body — walking, running, stretching, doing planks, pushups, squats, etc. — can also be done without breaking the bank.

“GLP1s are popular now for weight loss, but about half of patients stop taking them within a year, either due to cost or side effects,” said Fred Hutch epidemiologist and internist Anne McTiernan, MD, PhD, who studies the benefits of exercise. “Diet and exercise alone can achieve almost as high a degree of weight loss [as GLP-1s].” Read more about why Fred Hutch experts believe ‘exercise is medicine.’

McTiernan points to the 2018 U.S. Physical Activity Guidelines put out by the U.S. Department of Health and Human Services, or HHS, which provide recommendations for children, adults, older adults, pregnant peeps and those with chronic conditions. Guidelines, available online, advise adults get 2.5 to 5 hours a week of moderate-intensity exercise (think brisk walking, biking, dancing) along with a couple of sessions of strength training every week.

“Great strength exercises can be done at home, but they may not be intuitive,” she said. “Many free videos are available, though.” The NIH offers these tools and resources, including some exercise videos. The YMCA provides dozens of free fitness videos (even for beginners). Ditto for the National Health Service in the United Kingdom.  

Exercise too intimidating to think about this early in the year? Keep in mind, the guidelines — and the experts — also make it clear that “some physical activity is better than none.”

Eat more plants

Research continues to show that eating a colorful array of fruits and vegetables — leafy greens, blueberries, yellow squash, red tomatoes, black beans, etc. — keeps us replete with phytonutrients, powerful chemicals that act as antioxidants, boosting immunity, reducing inflammation, helping with DNA repair and slowing the aging process.

Ramsey’s third top tip is to bump your consumption of plants. Cruciferous vegetables like arugula, bok choy, broccoli, cabbage, cauliflower, kale, radishes and Swiss chard may give you the most bang for your cancer prevention buck. They contain high amounts of carotenoid, vitamins C and K, folate, manganese and potassium — and they’re an excellent source of fiber and glucosinolates, which inhibit cancer in all kinds of ways.

What you put in your mouth definitely matters — not just to your taste buds, but to your entire body.

Fred Hutch epidemiologist and naturopathic physician Heather Greenlee, ND, PhD, MPH, who focuses on cancer prevention and survivorship and is director of Fred Hutch’s Integrative Medicine Program, points to the Cook For Your Life website, which provides hundreds of free plant-based recipes and how-to videos for anyone who wants to try this form of “green chemoprevention.”

“In general, I would emphasize focusing on plant foods,” she said. “They’re packed with fiber and nutrients, including those that are anti-inflammatory. And plant protein is more affordable than meat. It’s also lower in saturated fat and higher in fiber.”

Limiting meat — especially red and processed meat — is also highly recommended by the American Institute for Cancer Research, especially for those concerned about colorectal cancer.

Greenlee also recommends getting nutrients from actual food, rather than pills or powders since “the supplement industry is poorly regulated and evidence regarding efficacy is limited for many of them.” Additionally, people often misuse them, resulting in harm. As this BMJ piece puts it: “Emergency department visits and hospitalizations for adverse events related to dietary supplements are common.”

Despite — or perhaps because there’s no regulation — supplements are big moneymakers, with one market estimate putting the U.S. nutritional supplements market at $112.6 billion in 2024, with the average American shelling out about $500 a year.

Another consideration: Greenlee said there are concerns that some supplements can actually negate cancer treatments —you’ll have the side effects but not the benefits — another key reason to discuss the use of any supplement with your cancer care team.

Get screened (and don’t forget the follow-up!)

We’re not able to screen for all cancers. Pancreatic and ovarian cancers, for instance, have no tests and are notoriously hard to spot early. But other common cancers — breast, colorectal, lung, skin, cervical, etc. — can be found early through preventive screening.

Ramsey’s fourth budget-friendly tip is to stay up to date on screenings, using the U.S. Preventive Service Task Force’s A- and B-rated tests, which offer moderate to even high net benefit. Cancer screenings (and any related follow-up exams) promoted by the USPSTF are generally covered by insurance, thanks to the Affordable Care Act, but the ACA and its policies are in flux, so this may change. At present, USPSTF recommendations are:

• Breast screening via mammogram every other year ages 40 to 74.
• Cervix screening via either HPV testing or Pap smear ages 21 to 65 (see the latest updates).
• Colorectal screening via colonoscopy, FIT test or other method ages 45 to 75.
• Lung screening via low-dose CT scan for those with a smoking history ages 50 to 80.
• Prostate screening via PSA blood test for those age 55 to 69 years is under review. USPSTF currently recommends discussing PSA’s benefits versus harms with your doctor.
• Skin screening USPSTF recommends sun-savvy behavior counseling for young adults, teens, kids and parents of young kids.

You can find more information on screening for breast cancer, colorectal cancer and lung cancer on the Fred Hutch website.

It’s even more important to follow-up with a care provider if the screening determines you need diagnostic testing or treatment. Fred Hutch pulmonologist Matthew “Matty” Triplette, MPH, PhD, who studies lung cancer screening strategies and is medical director for Fred Hutch’s Living Tobacco Free Services, said many people forget or forego the follow-up, defeating the whole purpose of screening. His research even shows half of people who test positive for lung cancer after a low-dose CT scan have delays in follow-up care.

For some, that meant their cancer became more advanced.

“We found a significant number of patients had clinical upstaging of their lung cancers by the time they eventually followed up,” he said.

But not all cancers — or cancer risks — are the same. That’s why researchers like Fred Hutch’s Ulrike “Riki” Peters, PhD, MPH, and Li Hsu, PhD, created a tool that stratifies who is most at risk, especially when it comes to aggressive cancers. The pair just launched a new colorectal cancer risk assessment tool that dovetails their polygenetic cancer risk research with your individual lifestyle and genetic data. Peters holds the Fred Hutch 40th Anniversary Endowed Chair.

Both DNA and environmental and lifestyle factors can affect your risk for cancer due to variants (i.e., acquired mutations) that can do damage over time. Most of the time, the body’s immune system destroys cells with harmful changes, but not always. Sometimes, they keep growing into a cancer.

Their new free website, MyGeneRisk Colon, is not a substitute for medical care or genetic counseling or screening, but it can tell you if your lifestyle — and/or your DNA — puts you at a higher risk. Those who’ve had DNA analysis done by AncestryDNA or 23andMe get a more personalized risk score, but DNA tests are not required. The tool is designed for anyone who hasn’t been diagnosed with colorectal cancer. Even better, MyGeneRisk assessments for other cancers are currently in the works.

Rethink your drink  

You probably knew this one was coming, since it’s officially Dry January and we just bid farewell to a year full of dire warnings about alcohol’s ill effects, including a report from the U.S. Surgeon General calling it one of the leading preventable causes of cancer in the country.

“Reducing alcohol consumption — or abstaining entirely — prevents cancer, because alcohol is linked to cancers of the breast, liver, colorectum, esophagus and head and neck,” said Bricker. “And cancer risk increases in a dose-response manner with alcohol intake.”

In other words, the more you drink, the more your risk. Aside from being harmful to your health, alcohol can also be pricey. And it’s deceptively easy to consume more than you intend.

A standard alcoholic drink in the United States, per the National Cancer Institute, contains 14 grams (or 0.6 ounces) of pure alcohol, which equates to 12 ounces of beer (a standard bottle); 8–10 ounces of malt liquor (a standard serving size); 5 ounces of wine (a typical glass) and 1.5 ounces of 80-proof liquor or distilled spirits (a “shot”)

But these amounts don’t necessarily reflect the “typical serving sizes people may encounter in daily life,” the NCI warns. They also don’t necessarily reflect the high alcohol content of, say, the newer craft beers.

“People often don’t know how much they’re drinking,” McTiernan said, pointing out that beer, wine and cocktails are served in all kinds of sizes. “If guidelines say stick to one drink a day, you can see how it might be hard to quantify unless you’re always having standard amounts, like a can or bottle of beer.”

The safest bet? Stop booze altogether, which, as it happens, is now in vogue.

“It’s trendy to drink less or not at all,” she said. “And people do like getting in on trends.”