How can Creating a Healing Environment help me? What the research says

Many types of exposures can affect your body terrainthe internal conditions of your body, including nutritional status, fitness, blood sugar balance, hormone balance, inflammation and more, your experience of side effects and symptoms, and your cancer risk. Some exposures are helpful, but others may be harmful. We summarize the evidence of exposures with the strongest evidence and also those that are common exposures. 

For suggestions on increasing beneficial exposures and reducing harmful ones, see Making changes in your environment ›

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

Learn more about how we research and rate therapies.

Exposures to nature

Exposures to nature can take several forms. While full immersion in a natural setting such as a forest is ideal, some benefits are found with exposure only to visual aspects of nature from indoors or to nature-based sounds.

Research details are listed in this therapy review.

Optimizing body terrain

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of improved immune function among adults and/or children with greater exposure to natural environments 

Preliminary evidence of less inflammation among people ranging from healthy young adults to elderly adults with chronic obstructive pulmonary disease (COPD) or hypertension participating in forest bathing

Preliminary evidence of health-promoting changes in skin and gut microbiota among urban daycare children with greater exposure to nature

Managing side effects and promoting wellness

Preliminary evidence of less anxiety among people with cancer in an educational facility with outlooks on natural scenery

Preliminary evidence of better wellness and spiritual sense among people spending time in nature or listening to nature sounds

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better sleep efficiency and sleep time among people with gastrointestinal tract cancer participating in forest therapy

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of benefit not specific to people with cancer

  • Modest evidence of lower anxiety among people participating in forest bathing or spending time in a forest
  • Modest evidence of less anxiety and agitation among people without cancer in critical care listening to recordings of nature-based sounds 
  • Modest evidence of lower blood pressure or heart rate among people with more exposure to nature
  • Modest evidence of better cognitive performance among people listening to nature-based sounds
  • Modest evidence of better mood among people listening to nature-based sounds
  • Modest evidence of less pain among people listening to recordings of nature-based sounds 
  • Modest evidence of better reported health and well-being among people with exposure to nature
  • Modest evidence of lower risk of stress-related disorders among people with dense vegetation near their residences
  • Modest evidence of less stress and annoyance among people listening to nature-based sounds

Reducing cancer risk

Modest evidence of lower cancer mortality over 8 years among women living near higher levels of vegetation 

Modest evidence of lower risk of breast cancer among people living in urban areas close to green space

Modest evidence of lower risk of childhood leukemia among children living in a large urban area within 250 m of an urban parks or urban wooded areas

Modest evidence of lower risk of prostate cancer among people with higher levels of residential greenness

Exposures to light and other radiation

Bright Light

Bright light during daytime hours comes naturally from the sun. Light from sources such as indoor lighting can also produce a similar light spectrum. Although bright light in daytime can improve sleep-wake rhythms, bright light—and especially blue-spectrum light—in the evening can interfere with your natural melatonin production. Higher concentrations of melatonin promote sleep, so bright light should be limited before sleep time.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better balance of hormones related to sleep (melatonin) and wakefulness (cortisol) among people exposed to bright or blue-enriched light during the day and not in the evening

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of improved sleep efficiency among fatigued people with cancer exposed to bright white light in the morning

Preliminary evidence of better mood, less fatigue or sleepiness, and less sleep disruption among people exposed to bright or blue-enriched light during waking hours and not during sleep hours

Electronic devices/blue light

Electronic devices such as mobile phones, televisions, or computer screens typically emit light in the blue section of the light spectrum. The effects of these devices on sleep are thought to be related to exposure to their blue light. Many newer devices have options to switch to more yellow or amber light in the evening. Use of electronics can also increase exposure to electromagnetic fields (EMFs) such as wi-fi. EMFs are considered separately below.

Symptoms not related to cancer

Preliminary evidence of less confusion-bewilderment but more errors on tasks among healthy adults using conventional LED (blue light) smartphones before bedtime

Preliminary evidence of more fatigue among young adults exposed to blue light at night (using a mobile phone after going to bed)

Preliminary evidence of some worse indicators of sleep quality among children and adults using electronic devices near bedtime or after going to bed, but no negative effects for adults using electronic devices for 2 hours at night following exposure to bright light for 6.5 hours earlier in the day

Electromagnetic fields

Many kinds of electromagnetic fields are generated by electrical appliances and devices, communications equipment, and electrical wiring and transmission. Some people may be more sensitive than others to EMFs, experiencing symptoms such as headaches or sleep disruption.

Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of effects from extremely low frequency electromagnetic fields (ELF-EMFs)—produced by power lines, electrical wiring, and electrical equipment—on hormone levels related to sleep

Preliminary evidence of shorter time to fall asleep with exposure to signals used in mobile radio and two-way transceivers (TETRA)―used primarily in emergency communications systems―or in mobile communications systems (GSM900 EMF)

Insufficient (conflicting) evidence of effects on sleep from exposure to wi-fi or cellular signals

Ionizing radiation

Sources of ionizing radiation include heat or light from the sun, medical diagnostic scans such as x-rays and CT scans, and gamma rays from radioactive elements. The most common radioactive exposure for most people is radon gas. Most other exposures to radioactive materials come from the workplace, although releases from nuclear power plants or uranium mines may also expose people in the community.

Ionizing radiation is classified a Group 1 carcinogen—there is enough evidence to conclude that it can cause cancer in humans—by the International Agency for Research on Cancer. We draw from the IARC summary, which we consider strong evidence, and add more recent research to it.

Ionizing radiation as a whole

Modest evidence of slightly higher risk of solid cancers among adults exposed to low cumulative doses  of ionizing radiation

Modest evidence of slightly higher risk of leukemia among adults exposed to low cumulative doses of ionizing radiation, but substantially higher risk (almost three times as high) of leukemia among children

Ionizing radiation from the sun or indoor tanning exposure

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of solid cancers other than melanoma and other skin cancer among people using indoor tanning devices

Modest evidence of lower risk of breast cancer among people getting sun exposure

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of higher risk of eye cancer (melanoma) among people exposed to UV-emitting tanning devices

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of a slightly higher risk of blood cancer among users of indoor tanning devices

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of lymphoma, with some differences among subtypes, among people with higher exposure to sunlight

Modest evidence of lower risk of Hodgkin lymphoma positive for Epstein-Barr virus among people with the highest ultraviolet radiation exposure

Good evidence of higher risk of melanoma and other skin cancer among people with higher exposures to the sun or to indoor tanning

Ionizing radiation from medical imaging such as x-rays

Strong evidence of higher risk of cancer, including secondary cancer, among people receiving radiation therapy

Strong evidence of higher risk of bladder cancer; brain cancer; female breast cancer; colon cancer; esophageal cancer; stomach cancer; various head, neck, and oral cancers; kidney cancer; leukemia; lung cancer; skin cancer (basal-cell carcinoma); bone cancer; or thyroid cancer among people exposed to x-rays or ionizing radiation from other medical imaging

Modest evidence of higher risk of rectal cancer among people with prostate cancer treated with radiotherapy

Ionizing radiation from radioactive materials

Strong evidence of higher risk of gallbladder cancer or liver cancer among people exposed to thorium

Strong evidence of higher risk of various head, neck, and oral cancers among people exposed to radium

Strong evidence of higher risk of leukemia among people exposed to thorium, phosphorus, or strontium

Strong evidence of higher risk of liver cancer, lung cancer, or bone cancer among people exposed to radon or plutonium

Strong evidence of higher risk of thyroid cancer among people exposed to radioiodines

Exposures to chemicals and other substances

Air pollution

Air pollution comes from many sources and can contain many chemicals. The evidence related to cancer focuses on the presence of tiny particulates (particulate matter, or PM) and nitrogen dioxide, common pollutants from vehicles and from industrial burning. Particulates can also come from wildfires, agriculture, mining, and other sources. Smoking tobacco and burning paraffin candles are main sources of indoor air particulates.

Cancer mortality 

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of small increases in mortality from cancer as a whole, bladder cancer, colorectal cancer, or kidney cancer among people without cancer at baseline with higher exposures to particulate air pollutants

Modest evidence of a small increase in lung cancer mortality among people without cancer at baseline with higher exposures to nitrogen dioxide, a marker of traffic-related air pollution

Cancer risk

Modest evidence of a small increase in risk of brain cancer among people exposed to ultrafine particulate air pollution

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of higher risk of breast cancer among people living in areas with higher air pollution levels

Modest evidence of higher risk of mouth and throat cancer, nonmelanoma skin cancer, or prostate cancer among people living in areas with higher levels of particulate air pollution

Good evidence of higher risk of leukemia among people exposed to air pollutants

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of colorectal cancer among people living in areas with higher levels of particulate matter pollution

Arsenic and other heavy metals

Arsenic occurs naturally in soil and groundwater, but it also is deposited as a result of mining, smelting, or industrial use. Tobacco smoke also contains arsenic. Arsenic is classified a Group 1 carcinogen—there is enough evidence to conclude that it can cause cancer in humans—by the International Agency for Research on Cancer (IARC). We draw from the IARC summary, which we consider strong evidence, and add more recent research to it.

Arsenic is one of many heavy metals. While some heavy metals are essential to plant growth, others are not, such as lead, cadmium, chromium, mercury, and aluminum. All are toxic.

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of higher risk of bladder cancer among people drinking water with higher levels of arsenic

Modest evidence of higher liver cancer mortalitydeath, or the death rate in a population; cancer studies often report all-cause mortality (death from any cause) and cancer-specific mortality (death due to the cancer under investigation) among people with the highest exposure to inorganic arsenic in drinking water

Strong evidence of higher risk of lung cancer among people drinking water with high levels of arsenic or exposed to airborne arsenic

Strong evidence of higher risk of skin cancer, primarily squamous cell carcinoma, among people drinking water with high levels of arsenic

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher risk of breast cancer among women with higher body levels of heavy metals

Asbestos

Asbestos is a mineral found in rock formations in many parts of the world. Because it is naturally resistant to heat, electricity, and corrosion, it was widely used in building and consumer products until its toxicity limited these uses. Asbestos is classified a Group 1 carcinogen—there is enough evidence to conclude that it can cause cancer in humans—by the International Agency for Research on Cancer (IARC). We draw from the IARC summary, which we consider strong evidence, and add more recent research to it.

Strong evidence of higher risk of colorectal cancer, stomach cancer, cancer of the larynx or pharynx, or ovarian cancer among people exposed to asbestos

Benzene

The major sources of benzene exposure are tobacco smoke, automobile service stations, exhaust from motor vehicles, and industrial emissions. Forest fires also produce benzene. Exposure is higher among people who manufacture or use plastics, lubricants, rubbers, dyes, detergents, drugs, and pesticides.

Good evidence of higher risk of leukemia among people exposed to benzene

Modest evidence of higher risk of non-Hodgkin lymphoma or B-cell lymphoma among people with high exposure to benzene

Bisphenol A (BPA)

Bisphenol A, or BPA, is a synthetic chemical used in plastics and resins and added to many everyday items, including cash register receipts. Most exposure comes from eating food or drinking water stored in containers that have BPA.

Body terrain

Good evidence of higher risk of type 2 diabetes among people without cancer with the highest body levels of BPA

Modest evidence of greater risk of obesity and elevated waist circumference among people with the highest body levels of bisphenol A (BPA)

Preliminary evidence of higher levels of inflammation and oxidative stress among postmenopausal women with higher body levels of BPA

Symptoms

Modest evidence of higher risk of high blood pressure among people with the highest body levels of BPA

Dioxins

Dioxins occur in nature but are also created by human processes. They accumulate in animal fats, including in animal-derived foods high in fat. TCDD is the primary dioxin of interest and is the most toxic. TCDD is classified a Group 1 carcinogen—there is enough evidence to conclude that it can cause cancer in humans—by the International Agency for Research on Cancer. We draw from the IARC summary, which we consider strong evidence, and add more recent research to it.

Strong evidence of higher risk of cancer as a whole, non-Hodgkin lymphoma, or soft-tissue sarcoma among people exposed to TCDD

Modest evidence of higher risk of prostate cancer among people exposed to TCDD

Endocrine-disrupting chemicals

Endocrine disrupting chemicals (EDCs) are any chemicals that can alter the hormonal signals that control and guide much of our growth and development, the way our organs function, and our ability to fight disease. Many pesticides are EDCs, as are some metals and many chemicals used in making common consumer products, such as phthalates and polychlorinated biphenyls (PCBs). Here we present evidence related to EDCs as a whole, PCBs, and phthalates. Evidence regarding some pesticides is assessed separately below. Bisphenol A, another EDC, is described above.

Modest evidence of hormone imbalance among women exposed to higher levels of specific endocrine-disrupting chemicals

Modest evidence of disrupted thyroid function among people with increasing body levels of diethylhexyl phthalate (DEHP)

Good evidence of substantially higher risk of osteosarcoma or lymphoma among children exposed to phthalates in medications

Preliminary evidence of higher risk of breast cancer among women with higher body levels of phthalates or PCBs

Formaldehyde

Formaldehyde-based resins are used in the manufacture of plywood, particleboard, furniture, cabinets, and other composite wood products. Formaldehyde is used in many cosmetic products as a preservative. Formaldehyde is also produced when smoking tobacco or using unvented fuel-burning appliances such as gas stoves or kerosene space heaters.

Formaldehyde is classified a Group 1 carcinogen—there is enough evidence to conclude that it can cause cancer in humans—by the International Agency for Research on Cancer (IARC). We draw from the IARC summary, which we consider strong evidence, and add more recent research to it.

Modest evidence of higher risk of brain cancer among people with the highest exposures to formaldehyde

Strong evidence of higher risk of nasopharyngeal cancer among people exposed to formaldehyde

Modest evidence of higher risk of sinonasal cancer among people with occupational exposure to formaldehyde

Good evidence of higher risk of leukemia among people with occupational exposure to formaldehyde

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lung cancer among people with the highest occupational exposures to formaldehyde

No evidence of an effect on risk of non-Hodgkin lymphoma among people with occupational exposure to formaldehyde in a combined analysis of studies

Hair dye or straightener

Hair dyes and straighteners are cosmetic products applied to the hair to alter color or straighten curly or kinky hair.

Weak evidence of slightly lower risk of cancer and cancer-related death as a whole, brain cancer, leukemia, or small lymphocytic lymphoma among people ever using hair dye

Modest evidence of slightly increased risk of breast cancer among people using permanent hair dye Preliminary evidence of slightly increased risk of breast cancer among people applying semi-permanent dye to others non-professionally

Weak evidence of increased risk of breast cancer among women with a sister with breast cancer and using hair straightener or applying it to others non-professionally

Weak evidence of a slightly higher risk of colorectal cancer, ovarian cancer, or basal cell carcinoma among people ever using hair dye

Modest evidence of higher risk of Hodgkin lymphoma among people ever using hair dye

Perfluoroalkyl substances (PFAS)

Perfluorinated chemicals are manufactured chemicals used widely in non-stick cookware, stain-resistant fabrics, and fire-fighting foams.

Modest evidence of lower immune response to vaccines among children exposed to higher levels of PFAS (perfluoroalkyl substances)

Preliminary evidence of increased risk of kidney or testicular cancers with greater exposure to PFOA, a perfluorinated chemical

Pesticides

Pesticides include all products meant to kill, repel, or control living organisms: herbicides, insecticides, rodenticides, nematicides, fungicides, and more. Because pesticide residues on food is common, we consider evidence regarding eating organic food an indication of less exposure to pesticides.

Although DDT was banned in the US in 1972, residues are still present in some foods, and people continue to be exposed. Animal and fatty foods contain the highest levels of DDT. This pesticide is still actively used in some countries, especially those with a high incidence of malaria.

Preliminary evidence of increased mortality among women with breast cancer with higher blood levels of an organochlorine pesticide

Strong evidence of immunosuppressionpartial or complete suppression of the immune response among people with higher exposures to DDT

Modest evidence of lower risk of overweight and obesity among people without cancer consuming organic foods more frequently and therefore less exposed to pesticide residues

Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of cancer among adults eating organic foods

Modest evidence of substantially higher risk of breast cancer among people exposed to some pesticides

Modest evidence of higher risk of brain tumors among children and young adults exposed to higher levels of residential pesticides

Good evidence of higher risk of childhood leukemia or lymphoma among children exposed to higher levels of indoor pesticides

Polycyclic aromatic hydrocarbons (PAHs)

Polycyclic aromatic hydrocarbons (PAHs) are toxic substances formed during combustion, including burning tobacco when smoking or grilling meat. Most of the studies showing an association with cancer involve occupational exposures which are typically far higher than you would have at home.

Good evidence of higher risk of lung cancer among workers in some industries with high occupational exposures to PAHs

Modest evidence of slightly higher risk of cancer as a whole among people living in urban areas characterized by higher concentrations of PAHs

Preliminary evidence of higher risk of childhood cancer among children exposed to PAHs from playgrounds surfaced with poured rubber

Modest evidence of higher risk of bladder cancer, breast cancer, or oral cancer among people with occupational exposures to PAHs

Weak evidence of higher risk of Hodgkin lymphoma among foundry workers with occupational exposures to PAHs

Vinyl chloride

Vinyl chloride is used in making PVC (polyvinyl chloride) plastic, used widely in construction and in wire coatings, vehicle upholstery, and plastic kitchen wares. Vinyl chloride is classified a Group 1 carcinogen—there is enough evidence to conclude that it can cause cancer in humans—by the International Agency for Research on Cancer (IARC). We draw from the IARC summary, which we consider strong evidence, and add more recent research to it.

Strong evidence of higher risk of liver cancer among people with occupational exposure to vinyl chloride

Wood dust

Wood dust is created during woodworking. It is classified a Group 1 carcinogen—there is enough evidence to conclude that it can cause cancer in humans—by the International Agency for Research on Cancer (IARC). We draw from the IARC summary, which we consider strong evidence, and add more recent research to it.

Strong evidence of a higher risk of cancer as a whole among people exposed to wood dust

Modest evidence of higher risk of nasal adenocarcinoma, nasopharyngeal cancer, or lung cancer among people with occupational exposure to wood dust

Other environmental exposures

Nighttime work

Many occupations involve working at night, either regularly or as part of rotating shifts. Nighttime work has mixed outcomes regarding cancer risk and survival, with benefits in some types of cancer and worse outcomes with others.

Cancer survival

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of higher mortality from cardiovascular causes among people with breast cancer working night shifts or rotating night shift work

Cancer risk

Higher risk

Good evidence of slightly higher risk of cancer mortality among people without cancer at baseline working at night

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of a slightly higher risk of stomach cancer among people working at night

Preliminary (conflicting) evidence of higher risk of prostate cancer among people working at night

No effect or unknown effect

Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of any higher risk of breast cancer among people working at night

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of colorectal cancer, non-Hodgkin lymphoma, ovarian cancer, or pancreatic cancer among people working at night in a combined analysis of studies

Lower risk

Good evidence of lower risk of lung cancer or skin cancer among people working at night

Sound

Sounds can be either pleasant or unpleasant. Noise is any sound that is loud or unpleasant or that causes disturbance. Evidence regarding nature-based sounds is described above in Nature.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of faster stress-recovery processes in laboratory experiments and better self-reported health conditions among people listening to positive soundscapes

Preliminary evidence of increased risk for anxiety among adults with increased exposure to traffic noise

Viruses and bacteria

A few viruses are known to cause cancer and are responsible for about 20% of total human cancer cases worldwide.

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of a higher risk of hepatocellular carcinoma among people with hepatitis B virus or hepatitis C virus

Strong evidence of a higher risk of stomach cancer, nasopharyngeal carcinoma, or several types of lymphoma among people with Epstein-Barr virus

Strong evidence of higher risk of cervical cancer and other ano-genital neoplasms or head and neck tumors among people with high-risk HPV strains

Strong evidence of higher risk of adult T-cell lymphoma among people with human T-lymphotropic virus type 1

Strong evidence of higher risk of Merkel cell carcinoma among people with Merkel cell polyomavirus

Strong evidence of higher risk of Kaposi’s sarcoma among people with human herpes virus 8

Good evidence of a higher risk stomach cancer among people with Helicobacter pylori infection

How Creating a Healing Environment relates to other practices and factors in cancer

Eating Well

Foods are sometimes contaminated with chemicals during production or processing.

Some cooking methods can create harmful exposures, such as charring and cooking with high heat.

Some food packaging or storage containers can contaminate food with harmful chemicals.

Foods can be a source of viruses and bacteria.

Managing Stress

As described above, healthy environmental exposures are linked to reduced stress.

Lower risk of stress-related disorders among people with more dense vegetation near their residences (modest evidence)significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently)

Lower blood pressure or heart rate among people with more exposure to nature (modest evidence)

Sleeping Well

As described above, healthy environmental exposures are linked to better sleep quality.

Better sleep quality and quantity among people with more exposure to green space (preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently))

Healthy habits

Manage your body weight

Greater risk of obesity and elevated waist circumference among people with the highest body levels of bisphenol A (BPA) (modest evidence)

Lower risk of overweight and obesity among people without cancer consuming organic foods more frequently and therefore less exposed to pesticide residues (modest evidence)

We are still researching healthy body weight; these assessments are from our work so far.

Don’t smoke

Tobacco smoke contains thousands of chemicals, including at least 70 known to cause cancer.223Harmful Chemicals in Tobacco Products. American Cancer Society. October 28, 2020. Viewed April 7, 2022. These include arsenic, benzene, formaldehyde, and PAHs, plus harmful air particulates as reviewed above.

Keep reading

Authors

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Maria Williams

Research and Communications Consultant
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Maria Williams is a research and communications consultant who brings over 15 years’ experience in research, consumer education, and science communication to CancerChoices. She has worked primarily in public health and environmental health.

Maria Williams Research and Communications Consultant

Reviewer

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Last update: May 25, 2022

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

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