Preventing Both Heart Disease and Cancer: Common Strategies Target Modifiable Risk Factors

Most people are aware that healthy eating and drinking, weight management, not smoking and staying physically active can prevent heart disease. But fewer realize that healthy lifestyle choices linked to modifiable risk factors can also reduce the chances of being diagnosed with many types of cancers.

Despite repeated messaging from medical experts and organizations, this combined concept of heart disease/cancer prevention has not exactly registered with the majority of the population, according to Baptist Health experts: Theodore Feldman, M.D., medical director of prevention and community health at Miami Cardiac & Vascular Institute; and Jane Mendez, M.D., chief of breast surgery at Miami Cancer Institute.

Theodore Feldman, M.D., medical director of prevention and community health at Miami Cardiac & Vascular Institute.

Drs. Feldman and Mendez made presentations recently during the “Lowering Your Risk for Heart Disease and Cancer” Baptist Health webinar. 


“And it makes sense,” stresses Dr. Feldman. “We know that obese people have a much greater incidence of developing certain types of cancers: breast cancer, prostate cancer, colon cancer. We know that if you smoke, you’re much more likely to develop lung cancer, bladder cancer, and other cancers.

“We know that if you drink alcohol excessively, you’re at much greater risk of developing liver cancer. In fact, eating and living a heart healthy life is eating and living a cancer-free life. These are things that we can all take personal responsibility about in terms of lifestyle choices.”

Breast Cancer and Modifiable Risk Factors

Dr. Mendez explains that a common misconception about breast cancer is that family history is a major risk factor.

Jane Mendez, M.D., chief of breast surgery at Miami Cancer Institute.

“Most women tell me: ‘I don’t have to worry about family breast cancer because they don’t have it in my family.’ But 85 percent of breast cancers occur sporadically, meaning that nobody has it in their family, and they don’t have a genetic mutation,” said Dr. Mendez. “In only 10 percent of patients, breast cancer occurs familial, meaning that they have it in their family. But we have not identified a genetic mutation and 5 percent are hereditary. Those are the ones where we can do genetic testing and we can identify a mutation that is actionable.”

Breast cancer is the most common type of cancer worldwide and the leading cause of cancer death among U.S. women, she adds. There are non-modifiable risk factors, or those women can’t control much if at all, such as gender, age, certain levels of exposure to the female hormone estrogen and the number of menstrual cycles in a woman’s lifetime.

“And the challenge is all the things that we can modify that are sometimes not as easy to do,” said Dr. Mendez. “That involves reversing poor diets, sedentary lifestyles, and issues with alcohol consumption. No. 1: We need to know our body. All of us have different metabolisms; we all have different body heights and weights, and we need to try to maintain that ideal body weight.”

The Obesity Factor and Knowing Your Numbers

The nation’s obesity epidemic is fueling both heart disease and higher rates of some cancers. From 1999 through 2018, the U.S. obesity prevalence increased from 30 percent to 42 percent, states the U.S. Centers for Disease Control and Prevention.

“Obesity is a risk factor for breast cancer because the estrogen levels will increase as the estrogen deposits itself in the fatty cells,” explains Dr. Mendez. “Usually the higher the estrogen levels, the higher predisposition to the possible development of breast cancer.”

When it comes to heart disease, there are plenty of misconceptions as well, said Dr. Feldman. Many people are not that familiar with their own vital numbers, including blood pressure, cholesterol, blood sugar and BMI (body mass index), which contribute to cardiovascular disease and increase the risks of heart attacks and strokes.

A recent survey found that 39 percent of U.S. adults thought they were in ideal cardiovascular health, points out Dr. Feldman. However, the reality is that less than 1 percent of adults are in ideal cardiovascular health. What’s ideal cardiovascular health — which also translates into cancer prevention as well?

‘Life’s Simple 7’ Prevention Plan

Responds Dr. Feldman: “The ideal in all of them would be: You never smoke, you have ideal body weight, you eat lots of fruits and vegetables, and you don’t eat processed foods. And you walk 10,000 steps a day. And then from the medical dashboard: You have a blood pressure below 120/80, you have a blood sugar below 100, and you have an LDL (the bad cholesterol) below 100. Only 1 percent of Americans meet all of those criteria.”

Seven metrics from the American Heart Association — which has been coined as ‘Life’s Simple 7’ — has been associated in a range of studies with not only the likelihood of reducing the chance of getting heart disease, but reducing the rate of many forms of cancer — as well as diabetes, obesity and chronic lung disease — by 50 percent to 80 percent. Life’s Simple 7 covers the vital areas of prevention: Managing blood pressure, controlling cholesterol, reducing blood sugar, exercising regularly, healthy eating, weight management and not smoking.

And as people get older, many don’t have a full understanding of the cancer screening guidelines for those at all risk levels. Moreover, the COVID-19 pandemic has resulted in delayed screenings and higher rates of late-stage diagnoses.

“Now, we’re seeing significantly delayed cancer diagnoses — women with more advanced stages of disease because they’ve delayed getting their screening mammograms done or delayed seeking medical attention. I encourage all of you — and your family members and friends — not to let the pandemic prevent early detection because we’ve seen the aftermath of delayed cancer diagnoses.”

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