The Impact of Cancer on Germany

A working group around Professor Hermann Brenner of the German Cancer Research Center (Deutsches Krebsforschungszentrum) in Heidelberg have investigated the most important modifiable risk factors for cancer. The concept of population-attributable fraction (PAF) basically depends on the number of risk-exposed people in the population, the extent to which the risk of the target disease is increased by the risk factor, and the incidence of the disease in the population. The authors used data from the literature on the most important modifiable risk factors and the cancers associated with them to determine the relevant PAFs, and from that the number of avoidable cases of cancer.

This work provides for the first time a set of systematically calculated figures for the epidemiologically most significant cancers and their risk factors for Germany. These figures show that, of the 440 000 new cases of cancer that occur every year in the 35- to 84-year-old age group, 165 000 (37.4%) are attributable to the investigated risk factors. That is, out of every five cases of cancer, two could be prevented. This, of course, is if all modifiable risk factors were completely eliminated.

Tobacco consumption, with an overall PAF for cancer just under 20%, is still the most important modifiable risk factor in Germany. For cancers such as breast, prostate, and colon, evidence-based early diagnosis plays a critical role in the reduction of mortality.

According to the WHO – World Health Organization, in 2018 Germany saw 71,888 cases of breast cancer, 66,749 of lung cancer, 62,641 of prostate cancer, 58,047 of colorectal cancer, 35, 738 of bladder and 313,679 of other cancers for a total of 608, 742 new cancer diagnoses. The number of people currently living with cancer in Germany is 1,943,860. The top five cancers for men are prostate, lung, colorectum, bladder, and melanoma. For women they are breast, lung, colorectum, melanoma, and uterine cancers.


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.  

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

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:

  1. Increased energy
  2. Improved treatment tolerance
  3. Decrease in pain
  4. Decrease in depression
  5. Better sleep
  6. Improved self-esteem/self-confidence
  7. Prevent weight gain and obesity
  8. Prevent.manage lymphedema
  9. Prevent cancer cachexia 
  10. Maintain independence
  11. Improved balance and strength
  12. Makes treatment more effective at destroying cancer cells

The benefits of exercise during recovery include:

  1. Increased range of motion
  2. Correct muscle imbalances that lead to pain and degeneration
  3. Increased energy
  4. Increased stamina
  5. Increases in strength and cardiovascular endurance
  6. Prevent osteoporosis, diabetes, lymphedema, future cancer, and damage to the heart and lungs 
  7. Decrease body fat and increase lean muscle mass
  8. Improve balance and fall prevention
  9. 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 becoming a Cancer Exercise Specialist in Germany, or would like to learn about bringing CETI’s training to your country, please contact 

REGISTER HERE FOR Home Study or live workshop in Dusseldorf, Germany on May 2-3, 2020



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