Professor Tuncer, you’re talking here about the situation in Turkey; you’re at the meeting here with us in Lyon. You have a lot of things happening on non-communicable diseases here, actually in Turkey, reflecting some of the emphasis the United Nations has recently given. What’s happening in Turkey at the moment with respect to cancer specifically?

The burden of non-communicable diseases is very big and huge and serious. The number of this kind of diseases is going to increase. This will be impossible to treat these diseases in the very close future, very near future, for example in 2023 or 2020, because it will cost too much money. So there is one way to solve this problem – prevent these diseases. So, for example, hypertension, cancer, diabetes, other chronic diseases we must prevent now.

So what you’re saying to me, then, is that because non-communicable diseases have been made quite an issue, if resources are limited the best thing to do is to prevent them. I suppose that’s a no-brainer, everybody would say that, but how do you do it, though?

Even your resources are not limited. You have to prevent this because the life quality is important now. The best thing is not to be ill and so the prevention is very important, that’s why we are here.

You’re a doctor though, doctors often don’t think about prevention because they’ve got their waiting room full of patients who want treatment. So how do you advise doctors to face up to this because they don’t even see the patients when they’re not ill? So what can they do?

But we face the reality. There is one treatment choice for these kinds of diseases, it’s prevention. There is no treatment, let me give you an example for cancer: 70% of cancer patients don’t get the high quality life after getting cancer. So we have to prevent, we need to prevent their life quality before to get the cancer. This is the prevention.

You’ve definitely sold me on the idea of prevention. What are you doing in Turkey? Can you tell me what progress you have made?

Yes, we have started a campaign in Turkey as a Minister of Health and all universities and NGOs. This is the health promotion campaign, the prevention for tobacco control, tobacco consumption and control, for example, blood sugars. We increase the physical activity, we prevent obesity and nutrition is important.

Let’s take some of those one at a time. Tobacco control is a big one, how is it going in Turkey and how do you succeed? You have to make it unfashionable to smoke, don’t you? Is that easy?

It’s good. It’s very good. Yes, yes. Not easy, it was not easy but Turkey and other countries, especially our region…

What did you do?

The important thing is the political decision and the politicians’ role. Our big chance is our Prime Minister because the Prime Minister is very tough for tobacco control. Otherwise it was impossible to get the chance for prevention of tobacco control.

Tell me what steps you’ve taken. You’ve taken laws, legal steps, to prevent tobacco use, have you? What did you do?

Yes. The law is nothing if your politicians don’t believe this.

So you have to win hearts and minds.

Yes, the action is important, more than having some law. We do action with politicians, with university academicians, with people and ordinary people. 90% of the Turkish population believe this action and so that’s why we are successful.

You mentioned obesity control, now that’s a difficult one, isn’t it?

Of course it is, as difficult as tobacco control in Turkey because we like to eat. But obesity control, the essential of obesity control is not to not eat. You can eat but you do the physical activity. Physical inactivity is a very dangerous thing and lifestyle must be physical activity.

Right, but eating is one thing, we have decisions we can make, but the government policy and the agricultural industry makes a big difference to those decisions because some foods are more available than others.

Yes, of course yes. But the balance is important. You can eat everything, everything in balance.

So are you in favour of changing agricultural policy or are you leaving it to individuals to make the choice about what to eat?

Actually the custom of eating in Turkey is very healthy but the new style, or this century the eating style is very…

Fast foods.

Yes, fast foods are very dangerous.

Salt, sugar.

Yes, salt, sugar.

Fizzy drinks.

Other types of high fat and delicious things; this is very delicious but dangerous at the same time. You can taste everything, you can eat everything, but in balance. You can taste everything but you can control total calories. If you can control total calories and if you are active physically don’t worry.

What kind of physical activities are you succeeding in increasing?

Thirty, forty minutes just walk every day.

And are people doing this now?

Yes.

So are people turning away from their motorcars?

Of course we drive because we are living in this century but everybody can walk 30-35 minutes every day.

You talked about diabetes as well?

Yes, diabetes is related very to obesity and nutrition. You can control diabetes by using nutrition and also physical activity. Also you can screen the whole population or some risky population by just maybe simple blood tests or urine tests.

So what’s your message to doctors about what they should be doing, and the medical community generally, to improve the health of the nation, to prevent non-communicable diseases?

Support prevention. All doctors must support prevention. This is the two sentences.

And you feel that in Turkey you’ve made important steps in that direction?

Yes, yes. All the doctors are getting education and training for prevention now in the medical studies. It is very important. Otherwise just focus, to be focussed on the treatment is nothing. If you look at the whole population of diseases it is impossible to treat all patients but we can prevent all of them.

Murat, thank you very much for coming to talk with ecancer.tv.

Thank you.