A 34-year-old marketing manager from Gurugram visited my clinic last year. His own definition fitted him? No cigarettes, some alcohol, cricket on the weekends. They even gave him a standing desk at his company. He dismissed his fatigue and a gradual, subtle change in his bowel habits for 8 months, thinking both were caused by the stress of his irregular and unhealthy diet. After we uncloaked the curtains, we revealed Stage III colorectal cancer.

He was not unlucky; cancer is a progressive outcome for millions of Indians in our country, and in some ways, he was winning.

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TheJournal of the National Cancer Institutepublished a groundbreaking study linking sedentary lifestyles to increased risk of colorectal, endometrial, and lung cancers. It does not matter if you go to the gym for an hour every day if you sit for ten hours. This is the "Active Couch Potato Syndrome" and its impact on India's urban desk workforce, where 12-14 hours of a sedentary lifestyle is the average.

Sedentary lifestyles can lead to many types of cancer

There is a silent epidemic of obesity in India.National Family Health Surveydata specify that approximately 40 per cent of women and 34 per cent of men in urban India are overweight or obese. Many are not fully aware, however, that body fat is not metabolically inactive. It synthesizes and secretes estrogen, insulin-like growth factor, and several pro-inflammatory cytokines, including TNF-alpha and IL-6.

This chronic, subtle inflammatory state is mechanistically associated with at least 13 malignancies, namely breast, colon, endometrial, pancreatic, liver, renal, and gallbladder. World Health Organization data conclude that excessive body weight is responsible for approximately 4 to 8 per cent of all cancers in the world. The fact that the obesity rate is statistically the highest among the 25 to 45 year old age range and the fact that this age range includes India's corporate class means that this is a current, not a future issue.

Stress is not the direct cause of the creation of cancerous cells. However, its lingering effects should not be neglected. The stress hormone cortisol dampens the activity of the immune system's natural killer cells, which primarily target early neoplastic cells. Employees who are chronically pressured by time, financial stress, and performance pressure operate with a biologically partially suppressed immune surveillance system.

On top of causing problems in the immune system, chronic stress also leads to many carcinogenic behaviors. These include smoking, increased alcohol consumption, disrupted sleep, and overeating. In my experience, many patients who are diagnosed with cancers related to their lifestyles have also been exposed to high levels of unmanaged occupational stress for many continuous years before their diagnoses.

In the modern world of work, late-night calls with colleagues in different time zones, working late in the office and at home, and exposure to artificial blue light are all part and parcel of working. TheInternational Agency for Research on Cancer(IARC) has classified night shift work as a probably carcinogenic activity primarily due to the effect it has on melatonin secretion and Circadian Disruption. Melatonin is not just a sleep hormone; it has been shown to inhibit cancer, particularly hormone-sensitive cancers.

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