More people in Taiwan died from cancer in 2018 than ever before, the Ministry of Health and Welfare (MOHW) reported in June, but the mortality rate was actually down when adjusted for age.
According to MOHW figures, 48,784 people died of various types of cancer in Taiwan in 2018, up 747, or 1.56 percent, from the previous year. That translated to a cancer patient dying every 10 minutes and 46 seconds in Taiwan, 10 seconds shorter than in 2017.
Cancer accounted for 28.2 percent of Taiwan’s 172,859 deaths in 2018, making malignant tumors the leading cause of death in Taiwan for the 37th consecutive year, the figures showed.
As a percentage of the population, cancer took the lives of 206.9 people per 100,000 population in 2018.
When adjusted for age based on the World Health Organization’s world population structure in 2000, however, it was 121.8 cancer deaths per 100,000 population, down 1.3 percent from a year earlier, the MOHW said in a statement.
This age-adjusted rate helps factor out the influence of a country’s age distribution on mortality numbers, and were it to rise it would point to factors other than age causing more cancer deaths.
Its 1.3 percent decline in 2018 led the MOHW to conclude, however, that Taiwan’s aging population was in fact the biggest factor in the rising number of cancer deaths.
Among cancers in 2018, lung cancers were the leading cause of death, followed by liver cancer, colon and anal cancer, and breast cancer, oral cancer, prostate cancer, stomach cancer, pancreatic cancer, esophageal cancer, and cervical cancer.
The main causes of death in Taiwan after cancer in 2018 were heart disease, pneumonia, cerebrovascular diseases, diabetes, accidents, chronic lower respiratory diseases, hypertension, nephrotic syndrome, and liver cirrhosis, according to the MOHW.
By age, accidents were the main cause of death for people aged 1-24, cancer and suicide were the two main causes of death for people 25-44, and cancer and chronic heart disease were the two top causes of death for people aged 45 and older, the MOHW said.
A series of epidemiological studies on major risk factors for various common cancers in Taiwan have been carried out. These cancer risk factors may be classified as infectious agents, lifestyle variables, dietary factors and susceptibility factors. Both hepatitis B virus (HBV) and hepatitis C virus (HCV) are major risk factors for liver cancer, mainly HCC, in Taiwan ( 15 – 22 ). The relative risk of developing HCC was similar for chronic HBV carrier status and HCV infection, but the population attributable risk percentage was much higher for HBV carrier status than for HCV infection ( 22 ). Elevated serological titers of antibodies against Epstein–Barr virus (EBV)-specific DNase (anti-EBV DNase) and IgA antibodies against EBV-specific viral capsid antigen (anti-EBV VCA IgA) were associated with an increased risk of NPC ( 23 – 26 ). Human papillomavirus (HPV) has been documented as a major risk factor for cervical cancer in Taiwan ( 27 , 28 ). However, the association between stomach cancer and seropositivity of antibodies against Helicobacter pylori was less striking ( 29 – 31 ).
Major lifestyle variables associated with an increased cancer risk in Taiwan include habits of cigarette smoking, alcohol drinking and betel nut chewing. Cigarette smoking habit has been found to increase the risk of lung cancer, HCC, oral cavity, NPC, esophageal, urinary bladder and cervical cancer in a dose–response relationship ( 17 , 19 , 22 , 23 , 25 , 26 , 32 – 35 ). Alcohol drinking habit has been documented as a risk factor for oral cavity cancer and HCC in Taiwan ( 17 , 19 , 34 ), while the habit of betel nut chewing is also associated with an increased risk of oral cavity cancer ( 34 ).
Consumption of preserved food has been associated with an increased risk of HCC ( 19 ), NPC ( 26 ) and stomach cancer ( 36 ). Frequent consumption of preserved soy beans was found to increase the risk of HCC ( 19 ) and NPC ( 26 ). Molecular epidemiological studies have shown an increased HCC risk associated with an elevated urinary ( 37 , 38 ) or serum level of aflatoxin ( 14 , 38 ). There was a dose–response relationship between risk of HCC and serum level of albumin adducts of aflatoxin B 1 ( 39 ). Frequent consumption of salted food has been found to be associated with an increased risk of stomach cancer in Taiwan ( 36 ). Low consumption of vegetables and low serum levels of β-carotene/retinol have been documented as risk factors for lung cancer ( 33 ), HCC ( 19 , 40 ), stomach cancer ( 36), NPC ( 26 ) and arsenic-induced skin cancer ( 41 ). Similarly, low serum selenium level has also been found to be a risk factor for HCC ( 42 ).
Through proper education cancer can be prevented, life expectancy can be increased, and quality of life both during and after treatment can be improved exponentially. The Cancer Exercise Training Institute (CETI), a United States-based organization, has trained over 10,000 health and fitness professionals to become Cancer Exercise Specialists since 2004. The language barrier has been an obstacle until now. CETI and it’s regional affiliates are bringing the Cancer Exercise Specialist Advanced Qualification training to China, Taiwan, Hong Kong, and Malaysia in November 2019. This live training will be conducted by Andrea Leonard, 35-year cancer survivor, PFP 2019 Personal Trainer of the Year, and President/Founder of the Cancer Exercise Training Institute.
Through the comprehensive training health and fitness professionals seeking to attain a higher level of mastery and work with cancer patients during and after cancer surgery and treatment and into survivorship. Participants will expand their skills as a CES and gain a complete understanding of the entire cancer process from diagnosis and treatment to reconstruction and survivorship. The unique and individualized programming will help to improve the patient’s ability to cope with the mental and physical stress following cancer diagnosis and treatment. The comprehensive programming covers 26 types of cancer, as well as pediatrics, with special emphasis on breast cancer and breast reconstruction.
“The Cancer Exercise Specialist is to CANCER what Cardiac Rehab. is to the HEART PATIENT.” – Andrea Leonard
After the two-day workshop, students will continue their studies through written manuals, video, and power point presentations followed by a 125-question final examination. Regular continuing education is required to maintain the high-standard of expertise required to work with this population.
The benefits of exercise during treatment include:
- Increased energy
- Improved treatment tolerance
- Decrease in pain
- Decrease in depression
- Better sleep
- Improved self-esteem/self-confidence
- Prevent weight gain and obesity
- Prevent.manage lymphedema
- Prevent cancer cachexia
- Maintain independence
- Improved balance and strength
- Makes treatment more effective at destroying cancer cells
The benefits of exercise during recovery include:
- Increased range of motion
- Correct muscle imbalances that lead to pain and degeneration
- Increased energy
- Increased stamina
- Increases in strength and cardiovascular endurance
- Prevent osteoporosis, diabetes, lymphedema, future cancer, and damage to the heart and lungs
- Decrease body fat and increase lean muscle mass
- Improve balance and fall prevention
- Improved self-esteem/self-confidence
Based on the tremendous amount of evidence to support the aforementioned lists, it is mind-boggling that so few cancer patients are told to exercise. For those who are given the green light to exercise, the big problem is not knowing where to start, how to safely progress, and how to prevent many of the complications associated with cancer treatment.
By training more allied health professionals worldwide, CETI is creating a global resource for medical professionals to be able to confidently refer their patients.
“Cancer strips you of everything. Your hair, your body parts, your dignity, your self-confidence, your strength and stamina, your finances, sometimes even your job or spouse. A Cancer Exercise Specialist can help the cancer patient regain control of their life and their body at a time that the patient feels they have no control.” – Andrea Leonard
If you are interested in learning more about our upcoming workshops in China, Hong Kong, Taiwan, and Singapore, or would like to learn about bringing CETI’s training to your country, please contact CETIguru@gmail.com
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