We have never been better at keeping people alive after cancer. So why are so many of us still getting it?

That’s the uncomfortable question buried inside the American Cancer Society’s latest numbers.

For the first time in U.S. history, the five-year survival rate for all cancers combined has reached 70%. Since cancer death rates peaked in 1991, an estimated 4.8 million deaths have been averted. Those are extraordinary victories, made possible by earlier detection, declining smoking rates, better treatments, and decades of research.

But there’s another side to the story.

More than 2.1 million Americans are expected to be diagnosed with cancer in 2026, and incidence continues to climb for a number of common cancers.

And then there’s a number that may be the most important of all:

An estimated 44% of cancer deaths in the United States are linked to potentially modifiable risk factors.

In other words, while we’ve poured enormous effort into getting better at finding and treating cancer, there is another part of the cancer story that deserves just as much attention:

What can we do before cancer ever gets the chance to start?

The answers aren’t exotic. They include some of the same things we’ve been talking about at the Templeton Wellness Foundation for years: what we eat, how much we move, maintaining a healthy weight, avoiding tobacco, limiting alcohol, protecting ourselves from excessive UV exposure, and reducing exposure to known carcinogens where we can.

None of these choices comes with a guarantee. Cancer is far too complicated for that.

But if nearly half of cancer deaths are connected to factors we have at least some power to change, isn’t it time prevention became a much bigger part of the conversation?

What Is Driving That 44%?

That 44% number isn’t based on guesswork.

American Cancer Society researchers examined major cancer risk factors that people can potentially change, then estimated how much each one contributes to cancer cases and deaths in the United States.

Smoking remains far and away the biggest culprit, accounting for about 29% of all cancer deaths in their analysis. Next came excess body weight, followed by alcohol consumption. Diet, physical inactivity, excessive UV exposure, secondhand smoke, and certain cancer-causing infections also contributed to the toll.

In fact, for 19 of the 30 types of cancer studied, more than half of the cases and deaths were attributed to the potentially modifiable risk factors researchers evaluated.

That’s a remarkable number.

But it also raises an obvious question: Where should we begin?

1. Smoking Is Still the Biggest Target

There isn’t much mystery here. We’ve known for decades that tobacco causes cancer, and the decline in smoking is one of the major reasons cancer death rates have fallen.

Yet smoking still accounts for more cancer deaths than any other modifiable risk factor.

If you smoke, quitting remains one of the most powerful steps you can take to reduce your cancer risk. And the benefits don’t end with lung cancer. Cigarette smoking has been linked to at least 12 different cancers.

But tobacco isn’t the whole story.

In fact, some of the other risks on the list may surprise you.

And we also alerted you to the very real dangers of radon, a silent, odorless, naturally occurring radioactive gas that can seep through cracks in floors, walls, foundations, and basements. Radon exposure is the second leading cause of lung cancer in the United States, responsible for an estimated 21,000 deaths each year.

2. Your Metabolic Health Matters More Than You May Think

After smoking, excess body weight was the second-largest modifiable contributor to cancer deaths in the ACS analysis.
And this isn’t simply about fitting into a smaller pair of jeans.

Fat tissue is biologically active. Excess body fat can affect hormones, insulin signaling, inflammation and other processes involved in how cells grow and divide.

That’s one reason maintaining a healthy weight is associated with lower risk for a number of cancers.

But we’d take this conversation one step further.

At the Templeton Wellness Foundation, we’ve talked repeatedly about the importance of looking beyond the bathroom scale to metabolic health. Blood sugar and insulin regulation matter, too. Someone can be at a seemingly normal weight and still have metabolic problems developing beneath the surface.

That’s why knowing numbers such as your fasting glucose, A1C and, when appropriate, fasting insulin can give you a much fuller picture of what’s happening inside your body.

>> Learn more: Starving Cancer: The Importance of Dieting, Fasting & Blood Sugar Control

3. Put More Cancer-Fighting Foods on Your Plate

When I was diagnosed with Stage 4 melanoma more than 40 years ago, changing the way I ate became an important part of my journey back to health. Nutrition has remained a cornerstone of my lifestyle ever since.

Today, research continues to uncover fascinating ways that individual foods and the compounds they contain may influence the biological processes involved in cancer.

Broccoli is a great example.

Broccoli and other cruciferous vegetables contain glucosinolates that can be converted into biologically active compounds such as sulforaphane. Researchers have studied sulforaphane for its effects on inflammation, detoxification enzymes, oxidative stress, cell signaling, and other pathways involved in cancer development.

But even broccoli comes with an interesting twist: how you prepare it can make a difference.

I’ve previously taken a closer look at the research on broccoli, sulforaphane, and the preparation methods that may help you get more of its beneficial compounds:

>> Learn More: The Best Form of Broccoli to Fight Cancer

And broccoli certainly isn’t alone. Berries, leafy greens, herbs and spices, seeds, fermented foods, and other nutrient-dense whole foods contain their own unique combinations of vitamins, minerals, fiber, antioxidants, and phytochemicals being studied for their potential role in supporting health and reducing cancer risk.

That’s why I don’t believe the answer is finding one miracle food. It’s making these foods part of what you eat every day.

If you’re wondering where to begin, I’ve put together a free guide featuring six of my favorite cancer-fighting foods, along with why I eat them and what makes each one special.

>> Download My FREE Cancer-Fighting Foods Guide

4. Don’t Overlook What’s in Your Glass

Here’s one cancer risk factor I suspect many people still underestimate: alcohol.

We spent years hearing that a glass of red wine with dinner might actually be good for us. But when it comes to cancer, the evidence tells a different story.

Alcohol is a known human carcinogen, and it’s now considered the third-leading preventable cause of cancer in the United States, behind tobacco and excess body weight.

In 2025, the U.S. Surgeon General issued an advisory specifically to draw attention to this connection. The report concluded that alcohol has a causal link to at least seven cancers, including breast cancer in women, colorectal, liver, esophageal, mouth, throat and laryngeal cancers.

And here’s the part that really got my attention:

For some cancers, particularly breast cancer, risk can begin to increase even at relatively low levels of alcohol consumption.
Why?

When your body breaks down alcohol, it produces a toxic chemical called acetaldehyde, which can damage DNA and interfere with the body’s ability to repair that damage. Alcohol can also increase oxidative stress and affect hormone levels, including estrogen, which may help explain some of its connection to breast cancer.

And red wine doesn’t get a free pass. Beer, wine and liquor all contain ethanol, the type of alcohol responsible for the cancer risk. The CDC is quite clear that all alcoholic beverages, including red and white wine, can increase cancer risk.

Does that mean an occasional glass of wine guarantees you’ll get cancer? Of course not.

But if the purpose of this article is to look honestly at the cancer risks we may have some power to change, what’s in our glass deserves a place right alongside what’s on our plate.

For anyone who wants to dig deeper, the National Cancer Institute has an excellent overview of the evidence, including how alcohol may cause cancer and how risk changes with consumption: Alcohol and Cancer Risk, National Cancer Institute

5. Exercise May Do More Than Help Keep the Weight Off

This may be the most fascinating part of the story.

We already know regular physical activity is associated with a lower risk of several cancers. But scientists are beginning to investigate what actually happens inside the body when we exercise.

One recent randomized trial involving 28 breast cancer survivors produced an intriguing result.

The women completed 12 weeks of either resistance training or high-intensity interval training. Researchers collected their blood before and after the exercise programs and then used the serum in laboratory experiments with triple-negative breast cancer cells.

After the training programs, cancer-cell growth in the laboratory was 22% lower with serum from the resistance-training group and 25% lower with serum from the HIIT group.

Read that again.

Something about the internal environment created by regular exercise made those cancer cells grow more slowly in the lab.

Researchers also observed increases in certain myokines, signaling molecules released by muscle that are being studied for potential cancer-suppressive effects.

Now, we need to keep this finding in perspective. This was a small study, and researchers weren’t showing that exercise shrank tumors in people. They were studying what happened to cancer cells exposed to participants’ serum in a laboratory.

But it adds another fascinating piece to a much bigger picture.

Exercise isn’t merely about burning calories. Every time you move your muscles, you’re changing the chemistry of your body.
And that may turn out to be one more reason movement deserves a place in the cancer-prevention conversation.

>> Learn more: Exercise-Induced Autophagy: Unlocking the Body’s Natural Cancer Defense

Not every modifiable cancer risk involves food, weight or exercise.

Radon, outdoor air pollution and occupational exposures to known carcinogens are among the environmental risks recognized in cancer-prevention research. The ACS prevention report specifically notes that exposure to occupational and environmental carcinogens remains widespread.

We don’t have complete control over everything we’re exposed to.

But we can learn where the biggest risks are, reduce unnecessary exposures when possible, and make better-informed decisions about the things we can control.

That’s really what prevention is about.

The Bottom Line

We’ve become remarkably good at fighting cancer once it arrives.

For the first time, the five-year survival rate for all cancers combined has reached 70%, and an estimated 4.8 million cancer deaths have been averted since the early 1990s.

That’s extraordinary progress.

But imagine what the next chapter could look like if we put the same determination into preventing cancer in the first place.