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• June 3, 1948, Sydney Farber and his colleagues
reported successful use of aminopterin to induce
temporary remission in children with lymphoid
• Gave hope what had been a uniformly fatal disease
might be amenable to treatment and, some dared to
hope, cure.
• In 1970, DeVita and his colleagues
showed that a combination of non–
cross-reactive chemotherapeutic
agents, the MOPP regimen could
induce sustained remission in
advanced Hodgkin's disease.
• From such beginnings, an
extraordinary success story unfolded,
and today, more than 75% of children
with cancer can be cured of their
• In the United States, there are
approximately 270,000 survivors of
pediatric cancer, or about 1 of every
640 adults between the ages of 20
and 39 years
• SGH survivors: In the last 10 years
• 87 : 10 yr survivor
• 195: 5yr survivor
• Future of these survivors?
• Cure may be accompanied by a
host of adverse events,
• Some may not appear for many
years after treatment has ended
long-term health
20,227 5-year survivors treated 1970
• Second cancers (standardized
mortality ratio 19.4),
• Cardiac causes
• Lungs (SMR, 9.2).
Study of 9535 survivors of childhood
• 44% reported having at least one of
below moderately or severely
– general health,
– mental health,
– functional status,
– limitations in activity,
– cancer-related pain, and
– cancer-related fear or anxiety)
Help yourself
Help anyone who gives you medical
Do things that will promote your health
No high risk behaviour
Help yourself from the
During course of treatment.
• Remain positive where outcome is
• Be caring but firm with the child. Issues
can be discussed with children but
sometimes decisions have to be made
for them especially when they are
• Don’t spoil the child
• Eat well
• Education
Help yourself from the
Know your disease and its
• Keeping your onco book which will have
your diagnosis and test results.
• Know what disease you have
• Know what treatment had been given
and side effects of treatment
• Stay in touch with the medical center or
clinic where you were originally treated
for cancer, at least once a year until 10
years post treatment
As the child grows
• Allow them to reach for their limits – don’t
curtail school activities eg camping , National
service etc
• Continue to instil discipline and religious values
– Less problem with mental health
– Less of sick role
• Treat them and siblings as equals
• Education important – delinquency avoided
• Tell the child about their disease once they
understand usu teenage years when they start
to surf the net
• Making use of available resources for
information and support.
• Maintain a good circle of friends
As the child grows
• Check with the doctor what side effects
to expect
• Look out for any abnormal lumps
especially over sites of radiation
• See a doctor immediately if there are
abnormal signs and symptoms eg:
bleeding from the anus, abdominal
• Have checkups once a year, with a
physical examination and
In adulthood

• Pap smear once sexually active

• Regular breast examination
• Mammograms from age 40
• From age 50, colonoscopy, usually
every 10yrs, to screen for colorectal
• Prostate-specific antigen (PSA) and
digital rectal examination (DRE)
should be offered annually,
beginning at age 50
Observe healthy lifestyle
• Exercising regularly;
• Diet: low-fat, high fiber diet;
• No excessive alcohol
• No tobacco
• No drugs
Socialize with peers No high risk sexual behaviour
•Adopt a physically active lifestyle.
At least 30 minutes of •Children and teens:
moderate to vigorous exercise At least 60 minutes per
on 5 or more days of the week; day of moderate to
vigorous exercise at least
45 to 60 minutes –even better 5 days per week.
lowering cancer risk.
lower risk of heart disease, high blood
pressure, diabetes, and osteoporosis
(bone thinning).
Tips on how to be more
• Use stairs not elevator.
• Walk or cycle to where you want to go.
• Walk to see co-workers, not phone or
send email.
• Dancing with your spouse or friends or
in groups.
• Plan active vacations rather than sit-
down trips.
• Join a sport- badminton, bowling,
• Use a stationary bicycle or treadmill
when watching TV.
• Plan your exercise routine to gradually
Maintain a healthy weight throughout life.
• Balance calorie intake with physical activity.
• Avoid excessive weight gain
• Aim for and maintain a healthy weight if currently
overweight or obese.
The healthiest way to reduce calories is :
don’t add sugar to drinks,
Reduce oil and fats,
Reduce drinks and foods high in calories, fat, and/or refined
sugars, but few or no nutrients.
Examples: fried food, cookies, cakes, candy, ice cream,
and sweetened soft drinks and alcohol.
Emphasis on plant sources; eat 5 or more servings of a variety
of vegetables and fruits every day.
Choose whole grains over processed (refined) grains.
Limit intake of processed and red meats.
• Alcohol is a known cause of cancers of the
mouth , pharynx (throat), larynx (voice box),
esophagus, liver, breast
• May also increase the risk of colon and rectum
• Combination of alcohol and tobacco increases
the risk of some cancers far more than the
effect of either drinking or smoking alone.
• Women at high risk of breast cancer should not
drinking any alcohol. Regular intake of even a
few drinks per week is linked to a higher of
breast cancer in women.
If you drink:
Not > 2 drinks per day for men and 1 drink a day for women.
A drink is defined as 12 ounces of beer (1can),
5 ounces of wine(1 glass), or 1.5 ounces (45mls) of 80-proof
distilled spirits, eg whisky.
Common Questions About Diet
and Cancer
• Many stories on food and cancer
• Single news reports may put too much
emphasis on what the advertiser wants
to promote.
• Good study usually involve many
people in many places, not 1 old lady
telling you after taking AB vitamin, all
diseases went away.
• It is not advisable to change diet or
activity levels based on a single study
or news report.
What are antioxidants?
• An antioxidant is a molecule capable of slowing or
preventing the oxidation of other molecules.
• Normal body metabolism is called oxidation
• Oxidation reactions can produce free radicals, which start
chain reactions that damage cells.
• Antioxidants terminate these chain reactions by removing
free radical intermediates,
• Although oxidation reactions are crucial for life, they can
also damage or kill cells; hence, plants and animals
maintain complex systems of multiple types of
• Because such damage is linked with increased cancer risk,
the so-called antioxidant nutrients are thought to protect
against cancer.
• Antioxidants include vitamin C, vitamin E, carotenoids, and
many other phytochemicals (chemicals from plants).
Do antioxidants reduce
cancer risk?
• Studies suggest that people who eat more
vegetables and fruits, which are rich sources of
antioxidants, may have a lower risk for some
types of cancer.
• Antioxidants dietary supplements are widely used
hoping to maintain health and prevent diseases
such as cancer and coronary heart disease.
• Although some studies have suggested
antioxidant supplements have health benefits,
• Other large clinical trials did not detect any
benefit for the formulations tested, and excess
supplementation may be harmful
• To reduce cancer risk, best advice is :
get your antioxidants through food, not
Will eating vegetables and
fruits lower cancer risk?
• Eating more vegetables and fruits
⇒ ↓ risk of lung, oral, esophageal,
stomach, and colon cancer.
• don't know which of the many
compounds in these foods are most
• Best advice : eat 5 or more types of
different colour vegetables and fruits
each day, example: 3 types of
vegetables plus 2 types of fruit.
Do vegetarian diets reduce
cancer risk?
• Low in saturated fats and high in fiber,
vitamins, and phytochemicals.
• BUT: It is not proven that a vegetarian
diet has any special benefits for the
prevention of cancer.
• Strict vegetarian diets that avoid all
animal products, including milk and
eggs not good for children – not enough
vitamin B12, zinc, and iron
• Diets including lean meats in small to
moderate amounts also healthy.
Can I get the nutritional
effects of vegetables and
fruits in a pill?
• No.
• Many healthful compounds are found
in vegetables and fruits, and these
compounds most likely work in
together to produce their helpful
• The small amount of dried powder in
the pills that are sold as being
equivalent to vegetables and fruits
often contains only a small fraction
of the levels contained in the whole
• Food is the best source of vitamins and
• Supplements, :helpful for some people,
eg pregnant women, women of
childbearing age, people with allergies,
food intolerances, or other problems.
• If a supplement is taken, the best
choice is a balanced
multivitamin/mineral supplement
containing no more than 100% of the
"Daily Requirement" of most nutrients
Can nutritional
supplements lower cancer
• No proof at this time that
supplements can reduce cancer risk.
• Some high-dose supplements may
actually increase cancer risk.
Do Vitamins lower cancer
Vitamin A
• Vitamin A supplements, whether in the form of beta-carotene or retinol,
have not been shown to lower cancer risk, and
• High-dose supplements may, in fact, increase the risk for lung cancer in
current and former smokers.
• Retinol can cause serious problems if too much is taken.
Vitamin C
• Many studies have linked intake of foods rich in vitamin C to a reduced risk
for cancer.
• But the few studies in which vitamin C has been given as a supplement
have not shown a reduced risk for cancer.
Vitamin D
• There is a growing body of evidence from studies that observie large
groups of people (not yet tested in clinical trials) that vitamin D may have
helpful effects on some types of cancer, including cancers of the colon,
prostate, and breast. Vitamin E
Vitamin E
• vitamin E is a powerful antioxidant.
• In one study, male smokers who took alpha-tocopherol had a lower risk of
prostate cancer
• But several other studies have not found the same link.
Can soy foods reduce
cancer risk?
• Women with breast cancer should take in only
moderate amounts of soy foods as part of a
healthy, plant-based diet. They should not ingest
very high levels of soy in their diet or take
concentrated sources of soy such as soy-
containing pills or powders, or supplements
containing high amounts of isoflavones.

• Little data to show soy supplements help reduce

cancer risk. High doses of soy could possibly
increase the risk of estrogen-responsive cancers,
such as breast or endometrial cancer.
Soy foods:
good source of
protein and a good
alternative to meat.

Contains several
some of which
have weak
estrogen activity
and appear to
protect against
dependent cancers
in animal studies.
Can drinking tea reduce
cancer risk?
• Some research suggest
tea might protect against
cancer because of its
antioxidant content.
• In animal studies, some
teas (including green
tea) shown to reduce
cancer risk,
• But yet to be proven to
reduce cancer risk in
Does eating fish protect

Fish is a rich source of omega-3 fatty acids.
• Studies in animals: these fatty acids suppress cancer
formation or slow down cancer growth,
• Limited evidence of a possible benefit in humans.
• Beware: some types of fish (large predatory fish such
as swordfish, tilefish, shark, and king mackerel) may
contain high levels of mercury, polychlorinated
biphenyls (PCBs), dioxins, and other environmental
• Women who are pregnant, breast-feeding, or planning
to become pregnant, and young children should not
eat these fish.
• People should vary the types of fish they eat to reduce
the chance of exposure to toxins.
• Research has not yet shown whether taking omega-3
or fish oil supplements produces the same possible
benefits as eating fish. .
Are "organic" foods more
effective in lowering cancer
• “Organic” is the “in” word.
• Plant grown without pesticides and
genetic modifications.
• No research exists to show such
foods are more effective in reducing
cancer risk than food produced by
usual farms.
Do food additives cause
• Many substances are added to foods to
preserve them and to enhance color,
flavor, and texture.
• New additives must be cleared by the
Food and Drug Administration (FDA)
before use.
• Additives are usually present in very
small quantities in food, and no
convincing evidence has shown that
any additive at these levels causes
human cancers.
Do high levels of salt in the
diet increase cancer risk?
• Studies in other
countries link diets
that contain large
amounts of foods
preserved by
salting and pickling
with an increased
risk of stomach,
and throat cancer.
• No evidence
suggests that
moderate levels of
salt used in cooking
or in flavoring
foods affect cancer
Do irradiated foods cause
• No.
• Radiation is used to kill harmful
organisms on foods in order to
extend their "shelf life."
• Radiation does not stay in the foods
after treatment, and eating
irradiated foods does not increase
cancer risk.
Do pesticides in foods
cause cancer?

Pesticides and herbicides can be toxic when used

No evidence shows that residues of pesticides
and herbicides at the low doses found in foods
increase the risk of cancer,
fruits and vegetables should be washed thoroughly before eating
Do processed meats cause
• Some studies have shown eating large
amounts of processed meat increased
risk of colorectal and stomach cancers.
• May be due to nitrites, which are added
to many luncheon meats, hams, and
hot dogs to maintain color and to
prevent bacterial growth.
• Eating processed meats and meats
preserved by methods involving smoke
or salt does increase exposure to
potential cancer-causing agents and
should be reduced as much as possible.
How does cooking meat affect
cancer risk?
• Adequate cooking is required to kill harmful
germs in meat.
• Some research suggests frying, broiling, or
grilling meats at very high temperatures
forms chemicals that might increase cancer
• These chemicals can damage DNA and
cause cancer in animals,
• But it is not clear how much they contribute
to the increased colorectal cancer risk seen
in people who eat large amounts of meat in
some studies.
• Techniques such as braising, steaming,
poaching, stewing, and microwaving meats
produce fewer of these chemicals.
How much water and other
fluids should I drink?

• Drinking water and

other liquids may
reduce the risk of
bladder cancer, as
water dilutes the
concentration of
cancer-causing agents
in the urine and
shortens the time in
which they are in
contact with the
bladder lining.
• Drinking at least 8 cups
of liquid a day is
Avoid Carcinogens
• Cancer is caused by changes (mutations) in a cell's
DNA -- its genetic "blueprint".
• Some of these changes may be caused by outside
exposures (environmental factors.)
• Substances and exposures that can lead to cancer
are called carcinogens
• Environmental factors include:
– lifestyle factors (nutrition, tobacco use, physical
activity, etc.),
– naturally occurring exposures (ultraviolet light,
radon, infectious agents, etc.),
– medical treatments (chemotherapy, radiation,
and immune system-suppressing drugs used
after organ transplants, etc.),
– workplace and household exposures, and
– pollution.
Carcinogens may have different levels of cancer-causing potential.
Risk of developing cancer depends on many factors, including how they are
exposed to a carcinogen, the length and intensity of the exposure, and the
person's genetic makeup.
National Toxicology Program 11th Report on
Carcinogens "Known to be human carcinogens "
• Aflatoxins • Ethylene oxide
• Alcoholic beverage consumption • Hepatitis B virus
• 4-Aminobiphenyl • Hepatitis C virus
• Analgesic mixtures containing phenacetin • Human papilloma viruses: some genital-mucosal
• Arsenic compounds, inorganic types
• Asbestos • Melphalan
• Azathioprine • Methoxsalen with ultraviolet A therapy (PUVA)
• Benzene • Mineral oils (untreated and mildly treated)
• Benzidine • Mustard gas
• Beryllium and beryllium compounds • 2-Naphthylamine
• 1,3-Butadiene • Neutrons
• 1,4-Butanediol dimethylsulfonate (busulfan, • Nickel compounds
Myleran®) • Oral tobacco products
• Cadmium and cadmium compounds • Radon
• Chlorambucil • Silica, crystalline (respirable size)
• 1-(2-Chloroethyl)-3-(4-methylcyclohexyl)-1- • Solar radiation
nitrosourea (MeCCNU) • Soots
• bis(chloromethyl) ether and technical-grade • Strong inorganic acid mists containing sulfuric acid
chloromethyl methyl ether • Sunlamps or sunbeds, exposure to
• Chromium hexavalent compounds • Tamoxifen
• Coal tar pitches • 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD);
• Coal tars "dioxin"
• Cyclophosphamide • Thiotepa
• Cyclosporin A (Ciclosporin) • Thorium dioxide
• Diethylstilbestrol (DES) • Tobacco smoking
• Dyes metabolized to benzidine • Vinyl chloride
• Environmental tobacco smoke • Ultraviolet radiation, broad spectrum UV radiation
• Estrogens, steroidal • Wood dust
• X-radiation and gamma radiation
• One of the most important
• Many kids start using tobacco by age 11. And many are
addicted by age 14.
• Talk to your children about the risks of tobacco use when
your children are 5 or 6 years old and continue through their
high school years.
– Tobacco use strains the heart, damages the lungs, and
can cause cancer.
– Smoking makes hair and clothes stink, causes bad
breath, and stains teeth and fingernails.
• Don't use tobacco around your children, don't offer it to
them, and don't leave it where they can easily get it.
• Talk about ways to say "no" to tobacco.
• Talk to your kids about the false glamorization of tobacco in
the media, such as movies, TV, and magazines.
• If you use tobacco yourself and don't want your
children to start, you can still influence their
decisions. You can speak to your child firsthand
– how you got started and what you thought
about it at the time
– how hard it is to quit
– how it has affected your health
– what it costs you, financially and socially
• Don't smoke indoors and don't allow indoor
smoking by anyone else.
• Don’t smoke in the car
Infections and Cancer
• Infections are linked to about 15% to 20% of cancers.
– In developed countries, < 10% of all cancers are
linked to infectious agents.
– In developing countries, infections account for as
much as 20% of all cancers.
• Some infections may cause long-term inflammation,
suppress a person's immune system, or directly affect
a cell's DNA.
Any of these pathways may lead to a higher risk of
• The risk of developing a cancer is also influenced by
other factors.
Example, infection with Helicobacter pylori (H. pylori)
bacteria may increase your risk of developing stomach
cancer, but what you eat, whether or not you smoke,
and other factors also influence your risk.
• Although the infections that influence cancer risk are
HPV and Vaccination
Human papilloma viruses (HPVs)
• Spread by contact (touch), including through sex.
• Very common in people who are sexually active.
• No effective treatments for HPV other than removing or
destroying cells that are known to be infected.
• Most genital HPV infections clear with time by the body's
immune system.
• Certain types of HPV cause of cervical cancer, which is the
second most common cancer among women but most infected
never develop cancer.

• Pap smear can detect pre-cancerous changes in cells in the

cervix that might be due to HPV infection, which can then be
treated, if needed. This treatment can prevent the development
of cancer.

• HPVs have a role in some cancers of the penis, anus, vagina, and
• Also been linked to cancers of the mouth, throat, head, and
•Vaccines against the types of HPV that cause cancer are now available -
(Gardasil®) and has been shown to help protect against infection from some of
these HPV types, and is now approved for use in females aged 9 to 26, before first
sexual encounter.
Hepatitis B virus (HBV) and
hepatitis C virus (HCV)and
• HBV and HCV cause viral hepatitis, a type of liver infection.
• Hepatitis A virus A can also cause hepatitis but only HBV and HCV can
cause chronic (long-term) infections that increase a person’s chance of
developing liver cancer.
• Liver cancers are related to HBV or HCV infection higher in Asia and
Malaysia, where both the infections and liver cancer are much more
• HBV and HCV are spread much the same way as HIV
-- through sharing needles, unprotected sex, or childbirth and blood
• HBV is more likely to cause symptoms, such as a flu-like illness and a
yellowing of the eyes and skin (jaundice). But most people recover
completely from HBV infection within a few months. Only a very small
percentage go on to become chronic carriers. These people have a
higher risk for liver cancer.
• HCV, on the other hand, is less likely to cause symptoms. But most
people with HCV develop chronic infections, which are more likely to
There are few drugs effective in treating hepatitis B or C,
Vaccine is available to prevent HBV infection.
In Malaysia, all children are vaccinated for Hep B
Unfortunately, there is no vaccine to prevent HCV at this time.
Human immunodeficiency
virus (HIV)
• HIV infection increases a person's risk of getting several types of
cancer, especially some linked to other viruses such as HHV-8 and
• HIV is acquired through intimate contact with blood, vaginal
secretions, breast milk, or semen from an HIV-infected person.
• HIV is not spread by insects, through water, or by casual contact
such as talking, shaking hands, hugging, sneezing, sharing dishes,
sharing a bathroom or kitchen, sharing telephones, or sharing
• Known routes of spread include:
– unprotected sex (oral, vaginal, or anal) with an HIV-infected
– injections with needles or injection equipment previously used
on an HIV-infected person
– prenatal and perinatal (during birth) exposure of infants from
mothers with HIV
– breast-feeding by mothers with HIV
– transfusion of blood products containing HIV (blood has been
tested since 1985)
Human immunodeficiency
virus (HIV)
• HIV infects and destroys white blood cells known as helper T cells,
which weakens the body's immune system.
• When the body is less able to fight off infections, other viruses such
as HPV may cause more damage to the cells. This damage may
trigger cancer.
• Many scientists believe that the immune system is also important in
attacking and destroying newly formed cancers. Weak immune
system may allow new cancers to survive to become a serious, life-
threatening tumor.
• HIV infection has been linked to a higher risk of developing of Kaposi
sarcoma, invasive cervical cancer, and certain kinds of lymphoma,
especially non-Hodgkin lymphoma and central nervous system
• Other forms of cancer that may be more likely to develop include:
– invasive anal cancer
– Hodgkin disease
– lung cancer
– cancer of the mouth and throat
– cancer of the testicles
Helicobacter pylori (H. pylori)
• Stomach cancer fourth most common cancer worldwide.
• Long-term infection of the stomach with H. pylori may lead to chronic
inflammation and damage to the inner layer of the stomach, including
ulcers. Some of these changes could lead to cancer over time,
especially cancer in the lower part of the stomach. H. pylori infection
is also linked with some types of lymphoma of the stomach.
• More than half of all cases of stomach cancer are linked to H. pylori
• About 1 in 3 adults has evidence of infection with H. pylori, and the
rate of infection is higher in older age groups. Researchers aren't
exactly sure how H. pylori may be spread from one person to another.
But most people who have these bacteria in their stomachs never
develop cancer.

• In animals, nitrites, commonly found in cured meats, some drinking

water, and certain vegetables can be converted by certain bacteria,
such as H. pylori, into compounds that have been found to cause
stomach cancer

• Antibiotics and other medicines can be used to treat H. pylori

• Doctors have given antibiotics to patients who have had superficial
stomach cancers removed in order to get rid of H. pylori infection.
This seems to have prevented new stomach cancers in those patients.
Cancers Caused by Radiation

Ionizing radiation is an effective way to treat certain kinds
of cancer.
• During radiation therapy, high doses of ionizing radiation
are directed at the cancer, resulting in the death of the
cancer cells.
• But, this can lead to DNA mutations in cells that survive the
radiation, which can eventually lead to the development of
another cancer (called a second primary cancer).
• When considering radiation therapy, benefits generally
outweigh the risks.
Some combinations of radiation therapy and
chemotherapy are more risky than others.
Research is needed in this area so that optimal treatment
can be given that minimizes the risk of the development of
secondary cancers.

• Following radiation therapy and/or chemotherapy.

– An increase in second primary tumors in the area being irradiated
has been observed
– Increased incidence of thyroid cancer and early-onset breast
Types of Cancer Associated
With Ionizing Radiation
• Leukemia -major cancer to arise from high-dose radiation
exposure, based on the experience of atomic blasts in
Appear as early as 2 years after acute radiation
Risk of developing leukemia is 5X > than in the general
Children 2X as sensitive as adults to the leukemia-
causing effects of radiation, and unborn children exposed to
radiation in the uterus are even more sensitive.

• Other cancers can result from radiation exposure, may take

longer to develop (usually at least 10 to 15 years).
The risk for developing any type of cancer in those highly
exposed to an atomic blast is about 50% higher than in
those not exposed.

• The risk of developing lung cancer is 50% higher,

• risk for multiple myeloma is >2X the general population
Non-Ionizing Radiation

• Non-ionizing radiation is low-frequency

radiation that does not have enough energy
to cause ionization in tissues,
• Common types of non-ionizing radiation
include ultraviolet rays, visible light,
electromagnetic fields, infrared radiation,
microwaves, and radiofrequency radiation
(radio waves).
• Electrical appliances, heaters, and cellular
phones emit (send out) non-ionizing
radiation waves.
• Of all the types of non-ionizing radiation,
only ultraviolet rays have been established
as a cancer-causing agent.
Ultraviolet (UV) Radiation
• The sun is the major source of ultraviolet (UV) radiation.
• Most skin cancers are a direct result of sunlight exposure. Both
basal cell and squamous cell cancers (the most common types of
skin cancer) are found on sun-exposed parts of the body, and their
occurrence is related to lifetime sun exposure.
• Melanoma, a potentially fatal type of skin cancer, is less
dependent on sun exposure and can develop on any area of the

• Ultraviolet radiation is divided into three wavelength ranges:

– UVA rays are involved in the aging of cells and produce some damage
to DNA.
– UVB rays are in the wavelength range mainly responsible for direct
damage to the DNA, and are thought to cause most skin cancers.
– UVC rays are not present in sunlight, but are present in mercury lamps.

While UVA and UVB rays make up only 1/10,000,000th of the sun's
wavelengths, they are primarily responsible for the damaging
effects of the sun on the skin.
Mobile Phones
• Results from the Swedish Interphone study of long-term cell phone use and
Results of the long-term cohort study, which linked data on all of the
420,095 cell phone users in Denmark between 1982 and 2002 to the Danish
Cancer Registry, indicate the same conclusions.

• Cell phone use, even for more than 10 years, was not associated with an
increased risk of developing brain tumors or cancer overall, nor was there an
association with any brain tumor subtypes or with tumors in any location
within the brain.

• One cancer that has been studied extensively is acoustic neuroma, a

relatively rare, slow-growing tumor of the acoustic nerve (which transmits
the sensation of hearing from the ear to the brain) that occurs in less than
one adult per 100,000 people per year.
• At least 9 epidemiological studies and one of the largest and most recent
studies that analyzed data from the 5 northern European countries have
looked for an association between the use of cell phones and acoustic
• Conclusion: “Suggested there is no substantial risk of acoustic neuroma in
the first decade after starting mobile phone use. However, an increase in
risk after longer term use or after a longer lag period could not be ruled out."