Cancer and our environment: Pollution, pesticides and the promise of healthier food and farming in Pakistan
Updated: 3 hours ago
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Dr. Farrukh A. Chishtie
Cancer prevention begins long before a patient enters a hospital. It begins in the air surrounding a home, the water drawn for drinking, the conditions inside a workplace and the soil in which food is grown.
For Pakistan, protecting these foundations of daily life must become an essential part of protecting public health. When harmful exposures are allowed to continue, the consequences may remain hidden for years, only becoming apparent when illness has already altered the life of an individual and the wellbeing of an entire family.
Consider the questions that confront an ordinary household. Is the water safe to drink? What is being released into the air by nearby traffic or industry? Have vegetables been grown with safe irrigation water? Are agricultural workers adequately protected when they handle pesticides? These questions connect environmental management with human health. They also reveal the limits of placing responsibility entirely on individuals. A family can make careful choices within its means, but clean air, safe water and responsible industrial practices require collective action.
The scale of the cancer burden demands attention. The International Agency for Research on Cancer estimates that Pakistan experienced approximately 190,300 new cancer cases and 119,700 cancer deaths in 2024. These are national estimates, rather than a complete count of individually registered diagnoses. They indicate a substantial burden of illness, suffering and loss that should place prevention alongside diagnosis and treatment at the centre of public policy.
Understanding changes in this burden requires care. More diagnoses over time can reflect population growth, ageing, changes in exposure and improvements in detection. Comparisons must also account for differences in the methods used to estimate cases. A rise in total numbers cannot, by itself, establish how much is caused by pollution or pesticides. That question requires reliable cancer registration and research linking specific exposures with diseases. Accurate measurement strengthens the case for action by showing where protection is most urgently needed.
The connection between environmental conditions and cancer is nevertheless well established for several hazards. WHO identifies air pollution as an important risk factor for lung cancer. Tobacco, certain infections, excess body weight, unhealthy diets and physical inactivity also contribute to the wider burden. An effective response must address these interacting concerns while investigating the exposures that occur in Pakistani communities and occupations.
Environmental protection should therefore be understood as an investment in prevention. Monitoring a water supply, controlling hazardous emissions or protecting a worker may appear far removed from cancer care. Yet these are precisely the kinds of measures through which society can reduce contact with harmful agents before disease develops. People should not have to choose between earning a livelihood and working in conditions that place their health at risk.
Food offers another important opportunity. A dietary pattern built around whole grains, pulses, vegetables and fruit is supported by cancer prevention guidance. In Pakistan, this can include familiar foods such as daal, chickpeas, beans, whole wheat and seasonal produce. The emphasis belongs on variety, affordability and regular nourishment. Healthier eating should be accessible through ordinary meals, rather than presented as a privilege requiring expensive products.
The promise of healthier food also invites a closer examination of how it is produced. Organic farming and other approaches that reduce dependence on hazardous inputs deserve attention within a broader commitment to safe agriculture. Their contribution must be assessed alongside irrigation quality, worker protection, storage and food testing. The aim is a food system that nourishes people while protecting the land and communities that sustain it.
How harmful exposures can become disease
The human body continually replaces old and damaged cells. Normally, this process is carefully controlled: cells divide when needed, respond to signals from surrounding tissues and stop growing when their work is complete. Cancer develops when changes in the instructions governing these processes allow abnormal cells to survive and multiply. Some can invade nearby tissues and spread to other parts of the body. Cancer is therefore a group of diseases involving failures in cellular regulation, with different causes and patterns of development. (NCI)
DNA carries the instructions that help our cells function. Some changes in DNA occur during ordinary cell division, while others can result from harmful exposures. Chemicals in tobacco smoke and ultraviolet radiation are examples of agents that can damage this genetic material. Whether exposure leads to cancer depends on several factors, including the amount involved, the duration of contact and individual susceptibility. Contact with a carcinogen does not mean that cancer is inevitable, but avoidable exposure remains an important target for prevention.
Persistent inflammation provides another route through which health can be affected. Inflammation is normally part of healing: the body responds to injury and helps repair damaged tissue. Problems arise when this response continues beyond its useful purpose. Chronic inflammation, including that associated with certain persistent infections or inflammatory conditions, can contribute to DNA damage over time. This helps explain why cancer prevention involves more than avoiding a single chemical. It also requires attention to infection, metabolic health and conditions that keep tissues under prolonged stress.
These processes often develop over extended periods. WHO describes cancer formation as a sequence of changes, with incidence increasing markedly with age as risks accumulate and cellular repair becomes less effective. This makes prevention a commitment whose benefits extend into the future. Reducing harmful exposure today can matter even when its full health benefits cannot immediately be counted. It also makes the history of a workplace or community relevant when researchers investigate patterns of disease.
Understanding the evidence
The word chemical is too broad to identify a danger. Water, nutrients and the substances that make up living organisms are all chemicals. The useful questions concern which substance is present, whether it can cause harm and how much reaches the body. Similarly, pesticides are not a single substance with one cancer risk. Their properties and the evidence concerning them differ.
IARC has classified the herbicide glyphosate and the insecticides malathion and diazinon as probably carcinogenic to humans. These assessments draw on evidence from human studies, animal experiments and research into biological mechanisms. They identify a potential cancer hazard; they do not calculate the likelihood that an individual will develop cancer from a particular exposure. The classification provides a reason for careful prevention and regulation without establishing that every use or trace residue carries the same risk.
For Pakistan, this distinction should guide investigation and action. Research needs to examine actual working conditions, the substances used and the ways people encounter them. Finding a contaminant in water or food is a reason to evaluate exposure and safety. Establishing that it caused a particular pattern of cancer requires further evidence. Authorities should communicate both what is known and what remains uncertain, while acting on established hazards.
The same care belongs in discussions of food as a healing agent. Nourishing food has an important place in maintaining health and supporting people through illness. However, no particular food, herb or supplement has been proven to cure cancer. Some supplements can also interfere with treatment. The constructive approach is to make good nutrition part of appropriate care, with individual advice where illness or treatment changes nutritional needs.
The direction for prevention is clear: reduce harmful exposures, strengthen the conditions that support health and ensure that people can obtain effective care. Cleaner air, safer water, responsible farming and affordable nourishment belong within the same public commitment. Understanding how damage occurs allows that commitment to move from concern towards practical protection.
The air we breathe, the risks we carry
Air pollution often attracts attention when visibility falls, eyes begin to sting and breathing becomes difficult. Yet the importance of cleaner air extends beyond the discomfort of a polluted day. Repeated exposure can contribute to illnesses that develop over many years, including cancer. Protecting the atmosphere around homes, schools and workplaces must therefore become a continuing public health responsibility, extending beyond seasonal warnings and emergency responses.
The International Agency for Research on Cancer has classified outdoor air pollution and the particulate matter within it as carcinogenic to humans. Its evaluation identified sufficient evidence that outdoor air pollution causes lung cancer. The mixture includes emissions from vehicles, factories, power generation and household combustion. People working close to pollution sources, including traffic police, drivers and street vendors, may experience greater exposure because of the location and duration of their work.
For Pakistan, these findings should shape how urban development and public health are planned together. A transport system should be assessed partly by the exposure it creates for passengers, workers and surrounding neighbourhoods. Industrial development should include effective emission controls and transparent monitoring from the beginning. Schools, hospitals and residential communities deserve particular consideration when decisions are made about the location of polluting activities. These are opportunities to prevent exposure before its consequences reach the health system.
Diesel exhaust deserves specific attention. IARC classifies it as carcinogenic to humans based on sufficient evidence linking exposure with lung cancer. This makes the management of exhaust around vehicles, machinery and enclosed working areas an occupational health concern. Maintenance, cleaner technologies and measures that prevent exhaust from accumulating should form part of workplace protection. Workers need clear information about the substances they encounter and practical means of reducing contact.
Protection must reach homes and workplaces
Pollution inside a home can also create serious risks. WHO identifies household air pollution from inefficient cooking systems and polluting fuels as a contributor to lung cancer and other diseases. Wood, animal dung, crop waste, coal and kerosene can produce harmful pollution when burned in open fires or inefficient stoves. Women and children often carry a disproportionate burden because of the time spent around household cooking activities. Access to cleaner cooking fuels and technologies is therefore an important health intervention.
In Pakistan, programs promoting cleaner cooking should account for the practical circumstances of families. Equipment must be affordable, fuel supplies reliable and systems suitable for daily cooking needs. A household cannot sustain a transition if the cleaner option becomes unavailable or unaffordable. Public support should connect technology with access, maintenance and education, allowing families to make lasting changes.
Workplace protection must also address hazards that may be less visible than smoke. All forms of asbestos are known to cause cancer, including lung cancer and mesothelioma, a cancer affecting the lining of the chest or abdomen. WHO and partner organisations identify ending the use of all forms of asbestos as the most effective way to eliminate diseases associated with it. Where asbestos containing materials are present, their management requires competent assessment and controlled procedures.
The broader principle is that earning a living should not require accepting preventable exposure. Employers and public authorities should identify hazardous processes, introduce safer alternatives and ensure that protection reaches workers in small enterprises as well as large industries. Cancer prevention belongs in decisions about transport, energy, construction and employment. Cleaner air is one of the foundations on which a healthier society can be built.
What enters our water and food
Water connects the environment with the body every day. It is consumed directly, used to prepare meals and applied to crops that later enter markets and kitchens. Protecting drinking water alone is therefore only part of the task. A comprehensive approach must consider the quality of water throughout the food system, together with the conditions under which food is grown, handled and stored.
Arsenic provides a particularly important example for Pakistan. WHO identifies the country among those where groundwater can contain elevated concentrations of naturally occurring inorganic arsenic. Prolonged exposure through drinking water and food can cause cancer and other serious health problems. Exposure can occur through drinking, food preparation and crops irrigated with contaminated water. A substance does not have to come from a factory to present a significant health hazard.
A study published in Science Advances in 2017 used nearly 1,200 groundwater samples to map arsenic hazards across Pakistan. It identified areas of concern in the Indus Valley, including around Lahore and Hyderabad. The researchers estimated that approximately 50 million to 60 million people used groundwater within areas identified as potentially at risk. This was a geographical risk estimate, not a count of people with arsenic poisoning or cancer. It remains an important argument for testing individual water sources and maintaining reliable surveillance.
The practical response should begin with accessible testing and clear communication. Communities need to know which sources have been assessed, what the results mean and where safe alternatives can be obtained. Treatment systems should be selected for the contaminant actually present and checked to confirm that they continue to work. WHO identifies preventing further exposure through a safe water supply as the most important intervention in affected communities. (who.int)
Industrial contamination requires a similarly specific approach. The presence of waste or discoloured water warrants investigation, but the health assessment must identify the substances involved and their concentrations. Describing every contaminant as equally carcinogenic can obscure the hazards that need the most urgent attention. Pakistan needs stronger connections between environmental laboratories, water authorities, agricultural departments and health researchers so that findings lead to corrective action.
Food safety continues after harvest
Another important concern arises when crops encounter conditions that favour mould growth. Certain moulds produce aflatoxins, which can contaminate foods such as maize, groundnuts, other nuts and some spices. WHO reports evidence that aflatoxins can cause liver cancer in humans. Contamination can develop before harvest or during storage, particularly under warm and damp conditions. This creates a prevention challenge that extends from the field to warehouses, shops and household cupboards.
Drying and storage therefore deserve a place in discussions of cancer prevention. Keeping susceptible foods properly dried and protecting them from moisture helps prevent mould growth. Ordinary cooking cannot be relied upon to remove all mycotoxins, many of which survive food processing. Prevention and testing are more dependable than attempting to rescue contaminated supplies after the problem has developed.
For Pakistan, this calls for investment in storage facilities, farmer training, market inspection and laboratory capacity. Small producers and traders need practical support to protect crops without suffering avoidable losses. Consumers also need information that helps them handle food safely without creating unnecessary fear of nutritious staples.
These concerns strengthen the case for healthier farming and food systems. An organic label, by itself, cannot establish the safety of irrigation water or the quality of storage. The promise of natural foods depends on the care taken throughout production and distribution. Supporting nourishment means protecting the water, soil and handling practices that allow food to reach the table safely.
Safer farming, healthier communities
Protecting people from harmful agricultural exposures begins with those who produce our food. Farmers and agricultural labourers need effective ways to protect crops without placing their own health, their families or surrounding communities at unnecessary risk. For Pakistan, this means making safer farming a practical and financially sustainable choice.
Pesticides differ in their hazards, and their use requires attention to the particular substance, application method and conditions of exposure. As discussed earlier, IARC has classified several pesticides as probably carcinogenic to humans. These findings strengthen the case for reducing avoidable contact and evaluating safer alternatives. They also underline the need for agricultural advice that extends beyond which product to purchase and how much to apply.
Integrated pest management offers an important approach. FAO describes it as a system that combines methods of crop protection while minimising pesticide use. Instead of treating spraying as an automatic response, farmers assess pest activity and decide whether intervention is necessary. The aim is to protect yields while taking account of economic, health and environmental concerns.
For Pakistan, agricultural extension programs should help farmers put this approach into practice through field observation, appropriate crop choices and access to effective alternatives. Advice should be available in local languages and supported by demonstrations under local growing conditions. Farmers should also receive clear guidance on safe handling, storage, protective equipment and the required interval between pesticide application and harvesting. Responsibility must extend to manufacturers, retailers and regulators, whose decisions shape what reaches the field.
Organic farming deserves support within this broader transition. Its value should be assessed through actual production practices, credible certification and protection of soil, water and workers. An organic label cannot establish that irrigation water is safe or that harvested food has been stored properly. Nor should the label be presented as a promise that a food prevents cancer. The goal is to reduce harmful exposures throughout production while maintaining reliable supplies of nutritious food.
Small farmers need assistance with the costs and uncertainties of changing practices. Training, access to suitable inputs, fair purchasing arrangements and dependable markets should accompany calls for reform. A healthier food system cannot be built by asking producers to absorb every financial risk while consumers pay premiums they cannot afford.
The same principle applies to household and community gardens. Growing vegetables can strengthen interest in food and encourage dietary variety, but the quality of soil, irrigation water and compost still matters. Careful cultivation should bring people closer to the sources of nourishment and deepen their commitment to protecting them.
Nourishment as a foundation for prevention and recovery
The strongest case for food in cancer prevention rests on the pattern of eating maintained over time. The World Cancer Research Fund recommends making whole grains, vegetables, fruit and pulses a major part of the daily diet. Its assessment supports the protective role of whole grains and dietary fibre against colorectal cancer, alongside the wider benefits of a varied diet rich in plant foods.
Pakistan already has a substantial foundation for this approach in familiar meals. Daal, chickpeas, beans, whole wheat roti, seasonal vegetables and whole fruit can provide variety without dependence on fashionable products. A practical household meal might combine lentils with vegetables and roti, or chickpeas with rice and a seasonal vegetable dish. Different foods can be rotated according to availability, preference and cost.
Improvement should also include reducing foods associated with increased risk. The World Cancer Research Fund advises limiting red meat and eating little, if any, processed meat. Beef, mutton and goat meat fall within the red meat category. Smaller portions, meals based on pulses and greater variety in protein sources can help families make this change while maintaining nutritional adequacy.
Healthy eating should remain accessible to families buying conventionally grown produce. Concern about pesticides must lead to safer agricultural practices and better monitoring, rather than discouraging people from eating vegetables and fruit. Affordability is central: public nutrition advice has limited value when recommended foods are beyond household budgets.
Supporting the body during treatment
For someone living with cancer, nourishment has an immediate and deeply practical role. Cancer and its treatment can affect appetite, swallowing, digestion and the ability to maintain weight. Adequate energy and protein help support strength and tissue repair. A dietitian can adapt food choices to symptoms and treatment needs, and some patients may require additional nutritional support. General prevention advice may need modification during active treatment.
This is where the healing role of food should be understood with care. Nourishing meals can support the person receiving treatment, but no individual food, herb or supplement has been proven to cure cancer. Ingredients such as turmeric, garlic and ginger can remain part of ordinary cooking without being promoted as substitutes for medical care. Concentrated supplements require particular caution because some can interfere with treatment.
Families can offer valuable support through meals that are manageable, appealing and suited to the patient. Compassion also means avoiding blame. Developing cancer does not establish that someone ate poorly, failed to exercise or neglected personal responsibility. Every patient deserves effective care, nourishment and dignity, regardless of how the illness arose.
A national responsibility to prevent avoidable harm
Household changes matter, but their reach depends on the conditions surrounding them. A family cannot remove industrial emissions from a neighbourhood. A farmer cannot independently regulate the pesticide market. A worker may have little power to demand safer materials or ventilation. Prevention must therefore connect personal action with enforceable public responsibilities.
Pakistan needs a cancer prevention agenda that brings health, agriculture, industry, labour and environmental protection into the same conversation. Priorities should include reliable drinking water, transparent pollution monitoring, safer chemical management and stronger food inspection. Agricultural support should reward practices that protect workers and reduce unnecessary hazardous inputs. Employers should be required to identify harmful exposures and implement effective controls.
Better cancer registration is equally important. Reliable information on diagnoses, occupations and geographical patterns can help researchers investigate possible links with exposure. Such work must distinguish association from causation while ensuring that established hazards are addressed promptly. Communities deserve clear explanations of findings and a visible response when contamination or unsafe working conditions are identified.
Environmental prevention should proceed alongside established measures against other cancer risks. Tobacco avoidance, physical activity, healthy weight, appropriate vaccination against hepatitis B and HPV, and access to early diagnosis all belong within a comprehensive response. WHO emphasises that many cancers can be successfully treated when detected early and managed effectively. Prevention and treatment must advance together.
Schools, hospitals and local organisations can help turn these commitments into daily practice. Public institutions should provide safe water and nutritious food, protect people from tobacco smoke and communicate health information responsibly. Community organisations can connect residents with testing services, support farmers adopting safer practices and advocate for action where pollution persists. These efforts become more effective when authorities publish results, assign responsibility and demonstrate progress.
Protecting life before illness begins
Pakistan should measure progress through the protection people can experience: water that has been tested, workplaces where hazards are controlled, food that is safe and affordable, and medical care that can be reached without financial ruin. Every environmental approval, agricultural policy and industrial inspection should be judged partly by its consequences for human health.
The cost of preventable disease is carried in interrupted education, lost livelihoods, exhausted savings and families facing grief. These losses demand more than occasional awareness campaigns. They demand sustained investment, honest enforcement and the resolve to place health above the convenience of allowing harmful practices to continue.
Clean air, safe water and nourishing food are foundations of a dignified life. Protecting them is an obligation to the people living today and to the children who will inherit our decisions. Cancer prevention begins wherever preventable harm is allowed to enter daily life. Pakistan must act there, before another family pays the price.
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