Woodlands Healing Research Center

Family, Environmental & Preventive Medicine

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Cancer Prevention & Treatment

Date: 06/29/2006

 

“There is no scientific evidence that food or other nutritional essentials are of any specific value in the control of cancer.”

AMA Declaration, 1949

 

“We must act on facts, and on the most accurate interpretation of them, using the best scientific information. That does not mean we must sit back until we have 100% evidence about everything. Where the state of the health of the people is at stake, the risks can be so high and the costs of corrective action so great, that prevention is better than cure. We must analyze the possible benefits and costs of action and inaction. Where there are significant risks of damage to the public health, we should be prepared to take action to diminish those risks even when the scientific knowledge is not conclusive, if the balance of likely costs and benefits justifies it.”

Richard Horton, Editor in chief, Lancet, July 1988

 

Prevention is the most important and most reliable cancer-fighting tool available. There is, indeed, much we can do to prevent this dreaded disease. Cancer prevention means preventing a first cancer episode and/or preventing a recurrence after successful treatment of a cancer. Creating and maintaining a healthy and strong immune system is the cornerstone to cancer prevention and treatment. Such measures that accomplish this effort include:

 

·        Diet and Nutrition

·        Exercise

·        Maintaining a Healthy Weight

·        Avoidance of Chemical Toxins and Radiation in the Home and the Environment

·        Stress Reduction and Building Emotional/Spiritual Health

 

American Cancer Society Guidelines for Cancer Prevention

We will begin our discussion of cancer prevent with the American Cancer Society (ASC) 1996 Advisory Committee’s Guidelines on diet, nutrition, and cancer prevention with healthy food choices and physical activity. The ACS guidelines are very conservative as they choose to wait for long-term definitive studies proving or disproving many recommendations for cancer prevention. Such course of action will take years and probably decades before those answers are found. Consequently, we have chosen to editorialize the ACS guidelines based on our opinions of the scientific literature on cancer prevention and immune system augmentation. You may then choose which and how many recommendations you want to incorporate into your health maintenance and cancer prevention program.

 

The ACS affirms (are we whole heartedly agree) that dietary practices and physical exercise along with smoking cessation, avoidance of occupational cancer causing substances and early detection are important factors in the prevention of cancer and cancer death. The details of their recommendations are as follows:

 

 

·        Choose most of the foods you eat from plant sources

Ø      Eat five or more servings of vegetable and fruits each day.

Ø      Include vegetables in every meal and choose fruits and vegetables for snacks.

Ø      Include grain products as whole grains instead of processed (white) grains

Ø      Choose beans as an alternative to meat

The evidence of eating increased vegetables and fruits to reduce the risks of colon cancer is strong. Evidence is present, but less strong for such cancers as breast and prostate.

 

·        Limit your intake of high fat foods, particularly from animal sources.

Ø      Replace fat rich foods with fruits, vegetables, grains and beans

Ø      Eat smaller portions of the high fat foods

Ø      Choose baked and broiled foods instead of fried foods

Ø      Select non fat and low fat milk and dairy products

Ø      Select lean cuts of meat

Ø      Eat smaller portions of meats

Ø      Choose beans, seafood, and poultry as an alternative to beef, pork and lamb

Ø      Select baked and broiled meats, seafood and poultry, rather than fried

High fat diets have been associated with an increase in the risk of cancers of the colon, rectum, prostate, breast and uterus.

 

·        Be physically active, achieve and maintain a healthy weight.

Ø      Be at least moderately active for 30 minutes or more on most days of the week.

Exercise has been shown to reduce the risks of colon, rectum, prostate, uterus, breast and kidney cancers.

 

·        Limit consumption of alcoholic beverages, if you drink at all.

Cancer rates start to rise with as few as two drinks per day. Alcohol consumption is associated with cancers of the mouth, esophagus, and breast.

 

The above guidelines are the general recommendations of the American Cancer Society. We will now explore them in more detail with extended information and recommendations.

 

Diet and Nutrition

With up to 60% of all cancers being related to dietary factors, diet and nutrition are perhaps the most important aspects of any cancer prevention program. The dietary habits to protect yourself from cancer involves eating a food diverse diet that maintains normal weight, reduces or eliminates carcinogenic (cancer causing) and hormone containing foods and increases the amount of protective nutrients you eat. You should be able to meet these goals with a diet emphasizing vegetables and organic foods.

 

These dietary principles of cancer prevention are built into the recommendations of the Basic Health Maintenance Diet as listed in the book It’s Only Natural, by Drs. Poesnecker, Buttram and Kracht and our separate handout with the same title. We strongly encourage you to use this extensive resource to help you meet the cancer prevention goals of reducing your exposure to contaminants and increasing your body’s ability to protect itself from cancer and other diseases. Furthermore, extensive and extremely helpful dietary and nutritional information may be found in the book Beating Cancer With Nutrition, by Patrick Quillin, PhD, R.D.

Foods with Protective Nutrients

The American Cancer Society states that nutrients and nutritional factors in the diet can protect the DNA from being damaged and can delay or prevent the development of cancer. There are now over 200 studies showing that a diet rich in fresh vegetables and fruits can substantially lower the risk for various types of cancer (so much for the AMA declaration if 1949!). When ever possible, include the following cancer protective foods and nutrients into your diet as much as taste and individual food intolerances permit:

 

·         VEGETABLES, VEGETABLES, VEGETABLES, and more VEGETABLES- they contain the antioxidants and minerals that protect the cells from damage and cancer development.

·         Carotenoids- are antioxidant compounds that make vegetables and fruits orange or yellow color. They function as “antioxidants” which protect the cells from “free radical” damage caused by chemicals and other substances.  Names of specific carotenoids include alpha and beta carotene, cryptoxanthin, zeaxsanthi, lutein and lycopene. Studies have shown that eating whole foods rich in these substances can reduce the risk of cancer. Men whose diets are high in tomato products (which contain the compound called lycopene) have a lower incidence of prostate cancer (Am J Epidemiology, Vol 133, 1991). There have been several studies demonstrating that beta-carotene supplementation by itself actually increased the risk of cancer in smokers. However, when taken in whole food as a balanced with other antioxidant, beta carotene is cancer protective. Foods high in Alpha and beta carotene include carrot, sweet potato, pumpkin, winter squash, yams, cantaloupe, beans, broccoli, Brussels sprouts, algae, spinach and other green leafy vegetables; Cryptoxanthin foods include oranges, grapes, lemons, tangerines, apples, corn, and poultry. Zeaxanthin foods include peaches and corn. Canthaxanthin foods include trout, crustaceans and mushrooms. Lutein foods include kale and spinach. Lycopene foods include tomato, watermelon, guava, and grapefruit.

      Broccoli & Tomatoes Together: Researchers from the University of Illinois at Urbana have determined that eating broccoli and tomatoes together may offer better protection against prostate cancer than eating either vegetable alone, reports Reuters. Why? Mixing the compounds from the two foods could have a synergistic effect. The study, which was done in rats, looked at the effect of these two foods as a unit. Previous research has found that each of them separately offer protection against cancer. For tomatoes, the lycopene--that's what makes them red--is likely the magic ingredient. For broccoli, it's a compound called glucosinolates.

    The study: Four groups of rats were injected with human prostate tumors that mimic human cancer to a certain degree (although not perfectly). Each of the rat groups were fed one of the following: dried, powdered tomato; dried broccoli; a combination of both; or a drug called finasteride that has been shown to reduce the benign growth of the prostate. The results: All the rats developed prostate cancer tumors, but the tumors grew more slowly and stayed smaller in the three groups of rats that had been given the food supplements. The rats given both broccoli and tomato had the smallest tumors, notes Reuters. "Separately, these two foods appear to have enormous cancer-fighting potential. Together, they bring out the best in each other and maximize the cancer-fighting effect," Erdman said. Journal of Nutrition

•       Flavonoids- flavonoids are a class of nutrients that act as specific antioxidants and help the body to optimize its use of vitamin C. These two cancer protective nutrients often coexist in fruits and vegetables.

·        The citrus bioflavonoids hesperitin in oranges and naringenin in grapefruit inhibit breast cancer cells in a test tube (Nutrition and Cancer, Vol 26, 1996).

·        The bioflavonoids called Anthocyanins are found in berries and grapes. Research shows that berries are among the fruits highest in antioxidant content and that they are excellent sources of several phytochemicals that seem to help block cancer development. In laboratory test tube studies, anthocyanins inhibit growth of lung, colon and leukemia cancer cells without affecting growth of healthy cells. Decreased cancer development is also seen in animals given anthocyanins. Black raspberries (containing ellagic acid which similar to resveratrol) prevented chemically induced esophageal cancer in one rat study. Strawberries, cranberries, and walnuts also contain ellagic acid. Ellagic acid also blocks metabolic pathways that can lead to cancer. In animals, it has inhibited development of colon, esophageal, liver, lung and skin cancers stemming from a variety of carcinogens. An essential question remains: Do normal portions of berries give us enough phytochemicals to get protective benefits or do we need to eat larger portions than standard 1/2 cup servings?  Some research does suggest that concentrations normally found in the blood after eating berries are enough to substantially decrease cancer cells’ growth and to stimulate their self-destruction, but more study is needed.

• Resveratrol and Pycnogenol are found in red grapes. Resveratrol is a potential anti cancer agent (Jang, M, Science, Vol 275, 1997). Resveratrol is most concentrated in red wines from cold regions (France and Canada). Once a bottle is open, resveratrol evaporates within 24 hours at room temperature and 1 week in the refrigerator. One glass of these specific wines per day may be cancer protective. However, alcohol is implicated as a breast cancer inducer (at more than 2 drinks per day) so moderation is absolutely essential. Any person with a family history of alcoholism or a women with a family history of breast cancer may choose to not use alcohol and may obtain similar benefits from grape juice or supplementation.

·        Crucifers- are vegetables that contain special cancer fighting nutrients (indoles and sulforaphanes) that offer some cancer protective effects, especially breast cancer (Zeligs, J of Medicinal Foods, 1998 and Michnovica, J Natl Cancer Inst, 1997). Crucifer foods include broccoli, cabbage, cauliflower, Brussels sprouts, mustard greens, collards, turnips, watercress and bok choy. Eat them raw or lightly steamed but avoid over cooking as heat destroys these special cancer-fighting nutrients. Broccoli Sprouts have 20-50 times more of these cancer fighting phytochemicals than the adult broccoli spears- use them liberally! Try for one serving of these crucifers per day for optimal cancer prevention.

·        Allium Vegetables- include garlic, onions, leeks, chives and shallots. They are loaded with selenium and sulfur rich amino acids and may be cancer protective in general and reduced breast cancer in rodents (Advances in Experimental Medicine and Biology, Vol 4.1, 1996).

·        Capsicum Vegetables- include green/red peppers and Chile peppers have a cancer protective phytonutrient (Carcinogenesis, Vol 16, 1995).

·        Fish Oil & Omega 3 Fatty Foods- Although high amounts of saturated fats and hydrogenated (trans) fats are associated with cancer; certain good, healthy fats (omega-3 fats) appear to be cancer protective (Nutrition Research, Vol 9, 1989; NCI Study, 1990; Bougnoiux P, BJ Cancer, 1994). Foods that contain these good omega 3 fats include cold-water fish, beans, raw nuts and flaxseeds/oil. Fish oil studies reveal anti-tumor effects by suppressing tumor growth and by tumor killing activity. Fish oil has been found to suppress both breast and colon cancer tumor cell growth and spread (Rose DP, J. Natl Cancer Inst, 1995 and Kontogiannea M, J Surg Res, 2000).

·        Lignans- slow down cancer spread and act as anti estrogens. Lignan containing foods include flaxseed, whole grains (oats and rice), legumes (lentils, peas, beans), walnuts and seeds.

·        Soy Foods- the effects of soy phytoestrogens on cancer are still being investigated and controversial. The National Cancer Institute is promoting soy’s role in protecting against breast and prostate cancer (JAMA, Vol 275, 1996). There are some conflicting results and can be explained by the fact that isoflavones are selective as to where in the body they are a “pro-estrogen” and where they act as an “anti-estrogen.” They may also be pro or anti estrogen depending on the dose-At low doses isoflavones have an estrogen-like stimulating effect, while at higher doses it appears to have anti estrogen effects. In the absence of any estrogens, genistein in low doses has a weak pro estrogen effect on breast cancer cells in a test tube (Hsieh, Cancer Res, 1998).

However, in that same test tube, when adding higher doses of genistein, it inhibits the growth of breast cancer cells (Zava, Nutr Cancer, 1997 and Peterson, Cell Growth Diff, 1996). That being said, in over 150 test tube studies, genistein has been found to inhibit the growth of cancer cells (Messina, Adjuvant Nutrition in Cancer Treatment Symposium, 1995 and Fotsis, Baillieres Clin Endocrinol Metab, 1998). Soy phytoestrogens inhibit the proliferative effect of both estrogens and xenoestrogens (chemicals that act like estrogens in the promotion of breast cancer) (Herman, J Nutr, 1995 and Verma, Nutr Cancer, 1998). An Italian test tube study found that the combination of genistein and the chemo drug Adriamycin showed an increased, synergistic effectiveness in halting human breast cancer cell growth (Monti, E, Anticancer Res, 1994).

Of the 25+ animal studies performed with soy, roughly 65% of them revealed a cancer preventing effect of soy (Messina, Nutr Cancer, 1994).

Epidemiological studies that have looked at the amount of soy in the diet and the incidence of breast cancer have reported that soy may be protective against cancer (Persky, J Nutr, 1995).

One case controlled study of 144 pairs of Australian women with newly diagnosed early breast cancer found three was a substantial reduction in breast cancer risk among women with high intake of phytoestrogens (Ingram, Lancet, 1997). In somewhat contradiction to these studies, other human studies have shown the soy isoflavones can stimulate the growth of normal breast tissue (McMichael-Phillips, Am J Clin Nutr, 1998 and Petrakis, Cancer Epidemiol Biomarkers Prev, 1996). Another human study revealed soy consumption decreased total estrogen and the estrogen metabolites that may be cancer stimulating (Xu, Cancer Epidemiol Biomarkers Prev, 1998).

Although encouraging, the human studies on soy and cancer are small, preliminary and are by no means conclusive. There are no well-controlled randomized human trials evaluating soy and female cancers. Soy rich foods also improved prostate health by blocking production of the testosterone (J Endocrinology, Vol 147, 1995).

The following precautions concern high dose soy intake:

·        High doses (200 mg/d) of soy isoflavones may inhibit thyroid function.

·        High doses (100-200 mg/d) of soy isoflavones can decrease estrogen levels in the premenopausal women. This may be good in women with an estrogen dominant state but may be undesirable in a women with a low estrogen state (Kronenberg, Menopause, 1999)

·        High soy diet was shown to interfere with coumadin (warfarin) therapy in patients with high cholesterol and after by pass surgery (Gaddi, Curr Ther Res Clin Exp, 1989).

·        Soy beans can be difficult for some to digest and cause gas and stomach upset

·        Soy contains high amounts of phytates that can block to absorption of calcium, magnesium, iron and zinc. Fermented soy products such as tempeh and miso have reduced amounts of phytates due to the fermentation process. Eating soy with meat or fish reduces the mineral blocking effect of phytates.

·        Some express concerns about high dose processed soy products and recommend just using the fermented types (tempeh and miso) and soy sprouts until more is known about the effects of high dose soy (Fallon and Enig, Health Freedom News, 1995).

• Forms and Doses of Soy: Soy powders, soluble in juice or milk, that list amounts of isoflavones per serving are now available in health food stores. Different products contain different amounts of isoflavones; be sure to check labels. Some experts recommend 40 to 80 milligrams of soy isoflavones a day.

Soy Food	Amount	Isoflavones (mg)
Textured soy protein granules	¼ cup	62
Roasted soy nuts	¼ cup	60
Tofu	½ cup	35
Tempeh	½ cup	35
Soy beverage powders	1-2 scoops	25-90 varies with products
Regular soy milk	1 cup	30
Low fat soy milk	1 cup	20
Roasted soy butter	2 tbsp	17
Cooked soybeans	½ cup	150
Soy isoflavones pills	Varies with product, check labels
Fermented soy isoflavones pills	Contains lower amounts but may be better absorbed

 

Nutritional Supplementation

“The proper mix of nutritional therapy and conventional treatments gives cancer patients a fighting chance.”

Patrick Quillin, Ph.D., R.D.

 

Dosage recommendations are geared toward our recommended prevention doses. In no way does this discussion imply that any of these are treatment recommendations for your individual condition. Treatment doses of these antioxidants should be individualized to each person’s unique biochemistry and medical condition under the supervision of a health care provider knowledgeable in this area of targeted pharmacological nutritional therapy.

 

Antioxidants

There is currently much controversy over the role of antioxidants when used together with standard cancer therapy like chemotherapy and radiation. Many medical and radiation oncologists recommend that their patients not take antioxidants while undergoing chemotherapy or radiation. Lets look at the facts concerning antioxidants before we rush to harsh conclusions. Antioxidants in general reduce the risk of cancer, improve over 100 health conditions, improve health and well-being, prevent and/or lessen the side effects of chemotherapy and help in cancer healing and recovery (Moss, R, Comprehensive Cancer Care 2000, Virginia). In a review of 130 studies on antioxidant (Vitamins C, E and Beta carotene), 120 of them documented their protective effects in cancer prevention (Block G, Nutr Reviews, 1992). Roughly 100 test tube studies and 100 animal studies have demonstrated that antioxidants protect the healthy tissues and cells of the body while allowing the cancer tumor cells to become more vulnerable to the effects of chemotherapy and radiation (Shimpo K. Am J Clin Nutr, 1991 & Okunieff P, Am J Clin Nutr, 1991 and Simone, Comprehensive Cancer Care 2000, Virginia). There are only a few human studies that have looked at antioxidants in cancer treatment and there are no human studies that have found antioxidants to decrease or interfere with the effectiveness of chemotherapy or radiation therapy!

·        Oncologist at West Virginia Medical School found that a once a day vitamin plus the following antioxidants of Vitamin A (40,000 IU), Vitamin B6 (100 mg), Vitamin C (2000 mg), Vitamin E (400 IU) and Zinc (90 mg) decreased bladder cancer recurrence by ½ (Lamm, DL, J Urol, 1994)

·        A study involving 18 patients with lung cancer, including 5 in the advanced stage, were treated with standard chemotherapy and radiation. They were also given megavitamin and antioxidant therapy that included 3-800 IU of Vit E and 2000-5000 mg of Vitamin C. 8 of the 18 had a 6 year survival (44%) compared to the normal 1% expected survival at 30 months with conventional therapy alone (Jaakkola K. Anticancer Res, 1992).

·        A non randomized trial of 129 cancer patients (included breast, ovary, uterus, cervix and other cancers) receiving conventional cancer treatments were studied. A control group of 31 patients who did not receive additional nutritional support lived an average of less than 6 months. The other 98 patients received large doses of vitamins and antioxidants (Vit C @ 12+ grams/d, B3 @ 1.5-3 g/, B6 @ 250 mg/d, Folic Acid 5-10 mg/d, Vit E 800 IU, Beta-carotene2 25-50,000 IU, Selenium 200-500 ug, Zinc 220 mg, CoEnzyme Q10 @ 300mg/d). Of these 98, 19 patients lived 10 months (75% improvement over the group who did not get nutritional therapy with their regular cancer therapy), 47 patients lived an average of 6 years and 32 patients who lived more than 10 years. (Hoffer A, J Orthomol Med, 1990, 1993, 1996).

 

The following discussion reviews the most common antioxidants that are used in supplementation form.

·        Vitamin A- Enhances cancer cell death in test tube experiments and lessens the harmful effect of the chem. Drug Adriamycin on the heart. It has been tested in Japanese clinical cancer trials. Recommended doses in the non-pregnant women would be 5000-10,000 units per day. Vitamin A is fat-soluble and can accumulate in the body. High doses can be toxic, especially in liver and kidney disorders.

·        Vitamin C- In September, 1999 an article published in the journal Cancer Research fueled the antioxidant controversy by concluding that Vitamin C interferes with chemotherapy. However, what the Memorial Sloan Kettering study actually found was that, in a test tube, more vitamin C went into cancer cells than normal cells. The researchers then falsely concluded that Vitamin C was bad for cancer. Vitamin C acts as both an antioxidant and pro-oxidant and once inside a cancer cell it can increase the effectiveness of chemotherapy, NOT decrease it! In a review of 90 epidemiological studies revealed the vast majority found statistically significant preventive effects of vitamin C in cancer. (Block, G. Am J Clin Nutr, 1991). Vitamin C also protects normal cells from the toxic effects of Adriamycin (Fujita K. Cancer Res, 1982), prolongs the lives of test animals, and enhances the drug cisplatin effects. In a test tube, Vitamin C enhances the effectiveness of chemo drugs against brain cancer cells (Prasad KN. Proc. Natl Acad. Sci, 1979). In a human study, 50 cancer patients were divided into two groups- both received radiation therapy but only one group also received 5 grams of Vit C per day. After one month, 87% of the vitamin C group had a complete response to therapy but only 55% of the radiation only group achieved similar results (Hanck, AB. Prog Clin Biol