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THE BESTSELLING BASIC WORK ON THE TOPIC, NOW COMPLETELY REVISED AND REWRITTEN, INCLUDING ALL THE NEWEST RESEARCH TEN PRINTINGS
CANCER PREVENTION
AND NlimriONAL THERAPIES Richard A. Passwater, PkD, author of The
New Super-Nutrition
and Chromium Picolinate
*§D 616.994 F26c Passwat e r R ,
Ca n c € r nutr
i
i
preven
t
i
o na
1
c
har d A ion a n
therapies
and
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•
Other books by Richard Passwater include:
Trace Minerals, Hair Analysis and Nutrition (with
Chromium
Picolinate
The Longevity The
New
Factor:
Chromium
Superantioxidant
—
Picolinate
Plus
SUPERNUTRITION: Megavitamin Revolution SUPERNUTRITION for Healthy Hearts Super Calorie, Carbohydrate Counter
The Easy No-Flab Diet Selenium as Food and Medicine
The Slendernow Diet Guide
to
Fluorescence Literature,
Volumes 1-3
Elmer Cranton, M.D.)
Cancer Prevention
and Nutritional
Therapies Richard A. Passwater, Ph.D.
Keats Publishing, Inc.
3^ New
Canaan, Connecticut
Allen County Public Library
900 Webster Street PO Box 2270 Fort Wayne, IN 46801-2270
Cancer Prevention and Nutritional Therapies
is
not intended
as
medical advice.
Its
intent
is
solely
informational and educational. Please consult a health professional should the need for one be indicated.
CANCER PREVENTION AND NUTRITIONAL THERAPIES Pivot Original Health Edition published in 1978 and a revised edition published in 1983 Cancer and
Its
©
1978 by Richard A. Passwater, Ph.D. © 1983 by Richard A. Passwater, Ph.D. The latest material in this totally revised and updated edition copyright Passwater, Ph.D. Copyright
New
as
Nutritional Therapies.
material copyright
All rights reserved.
No
part
of
this
book may be reproduced
in
©
1993 by Richard A.
any form without the written
consent of the publisher. Printed in the United States of America Library of Congress Cataloging-in-Publication Data Passwater, Richard A. [Totally revised and updated fact/book on cancer prevention and nutritional therapies] Cancer prevention and nutritional therapies, Totally revised and updated ed. cm. p. Previous ed. published under title: Revised, updated fact/book on cancer and its nutritional
—
therapies, 1983.
Includes bibliographical references and index.
ISBN 0-87983-607-5
—
(pbk.)
:
$14.95
—
Cancer Diet therapy. 2. Cancer Nutritional Title: Cancer prevention and nutritional therapies. RC271.D52P37 1993 616.99'4—dc20 1.
aspects.
3.
Cancer
—Prevention.
I.
93-22989
CIP Keats Publishing, Inc.
27 Pine
New
Street,
Canaan,
Box 876
CT
06840-0876
Contents
1
The Scope of This Book
3
2
My
8
3
Waging War on Cancer
4
Lifestyle
5
6
What Causes Cancer? The Battleground: Antioxidants
7
Vitamin
33
Vitamin
A C
and Beta-Carotene
8
Against Cancer
42
9
Vitamin
E
Against Cancer
51
Research
13
Changes Prevent Most Cancers
17
22 Versus Free Radicals
29
Selenium Against Cancer
58
11
Sulfur-Containing Antioxidants
69
12
Trace Minerals, Antioxidant Enzymes and Pro-Oxidants
72
13
Vitamin
B Complex
14
Vitamin
D
15
Other Protective Food Factors
16
Shark Cartilage Destroys Cancer Tumors
17
Other Therapies and Basic Strategy
105
18
Lung Cancer
124
19
Breast Cancer
129
20
Colon Cancer
153
21
Skin Cancer
166
22
Prostate
Cancer
171
23
Cervical Cancer
179
10
Against Cancer
and Calcium Protect Against Some Cancers
Facts
and Hints
75
79 89
94
CONTENTS
VI
Appendix
A The Immune
Appendix
B
Vitamin C's Role in Preventing Cancer
189
Appendix
C
Vitamin E's Action in Preventing Cancer
193
Appendix
D
The
System
Influence of Vitamin
185
A
and Carotenoids
on Cancer
199
Appendix E Dietary Fiber and Cancer Prevention
203
Appendix F Dietary Fat Intake and Risk of Cancer
205
Bibliography
213
Index
217
About
the
Author
227
Cancer Prevention
and Nutritional
Therapies
CHAPTER
1
The Scope of This Book
show you how to you won't get cancer in the first place. This book will also help you overcome cancer if it is too late for protective measures. The information in earlier editions of this book has been proved by the test of time and the Cancer Prevention and Nutritional Therapies will
your protection
increase
against cancer so that
experience of thousands who have shared their success stories with me. Cancer and Its Nutritional Therapies was first published in 1978 and was updated in 1983. Those editions were based on my own research between 1968 and 1979, plus the research from a handful
of other
scientists.
This
is
a
complete revision that adds
mation to the already proven information from the
Now
new
infor-
earlier editions.
leading scientists, including those of the National Cancer
Institute
(NCI), agree with the teachings of the
no longer have
to rely primarily
biochemical explanations
—now
I
on
my
earlier editions.
I
laboratory research and
can also rely on the concurring
findings of hundreds of studies of real people. These studies are so
convincing that the
NCI
is
funding dozens of large-scale
studies to provide the final data to conclusively
conclusions
I
had come to through
my
earlier
clinical
prove the same findings.
I
will
discuss these findings in detail in later chapters.
You
don't have to wait another twenty years for
firmation.
book
The
are safe
this final
con-
nutritional protective measures presented in this
—and they
will protect
but also against heart disease and
you not only
many
against cancer
other diseases.
CANCER PREVENTION AND NUTRITIONAL THERAPIES
4
And
place
I
make
my
emphasis on
YOU. You
are the only person
you to protect yourself. You can choose to fight cancer before you get it or after you get it. You will not have to make drastic dietary changes. You can benefit from the protective measures presented in this book without changing your basic diet. However, those with bad diets will have additional benefit if they make at least some changes. This is a book that will help everyone, not just those who have "holier than thou" diets. I want to help real people in the real world. It does little good to preach dietary practices that people will choose not to follow. You can use the information in this book to select what protective modifications you can realistically make to your own lifestyle. It may be practical for you to merely add nutritional supplements to your diet now, and then when you are able, you may also make modifications such as to stop smoking or lower the that can
the difference!
content of your
fat
The
vast majority
It is
up
to
diet, if applicable.
of cancers are preventable. Smoking and diet
most of these cancers. It goes without saying risks of cancer and heart disease, no one should smoke. However, I understand that there are people, including my own family members, who have tried to stop smoking but have been unsuccessful so far. I encourage them to quit, but in the meantime, I want to protect them as much as possible. The evidence is that moderate smokers who are well nourished with antioxidant nutrients have less risk of cancer than nonsmokers who are responsible for that because
of the great
are poorly nourished. I
stated in People
magazine in December 1980
that
"No one
under 80 should get heart disease and if you have enough vitamins and no genetic defects you can stop a cancer cell from ever forming." life
The
guidelines in this
book
are a formula for a cancer-free
of people. As I discussed in The New Supemutrition, no such thing as a 100 percent guarantee of protection cancer. Optimal nutrition will offer you greater protection
for millions
"There against
is
against cancer than being undernourished." Several scientists
gone on record as to the involvement of and their estimates range from 35 percent
diet as a cause
to
have
of cancer,
80 percent. However,
these scientists have only considered the roles of the dietary factors
THE SCOPE OF THIS BOOK such
as fat
and
make up
fiber that
much of the
and they have overlooked
percentage of the
a large
role
diet,
of the micronutrients
(vitamins and minerals) that protect against cancers caused
by other smoking and chemicals in the environment. These cancers are not caused by poor diet, but micronutrients can stop their promotion into cancer. This book details how to use micronutrients and reduction of exposure to cancer-initiating agents so as to achieve a 90 agents such as
and
percent reduction in cancer risk It's
incidence!
time for people to focus on the good news: not everything
causes cancer, and easy lifestyle changes can protect against cancer.
A
few
basic antioxidant nutrients
—such
as
vitamin
A
and
its
pre-
cursor beta-carotene; vitamin C; vitamin E; and the trace mineral
—
selenium will
offer great protection against
choose to eat more
nutrients, but
many
even
many
ents in
Hopefully, you
that contain these
you can get these protective nutriyou can protect yourself against
if you don't,
vitamin
cancer.
and vegetables
fruits
Yes,
pills.
cancers by simply taking the right vitamins in the proper
amount.
When
Margaret Heckler was Secretary of the U.S. Department
Human
of Health and
Services, she
noted that 80 percent of
all
were caused by smoking, what we eat and much sun exposure and other environmental factors. She said, "Too few realize the simple truth that cancer is often caused by the way we live, and its risks can be reduced by the daily choices we make in our lives. We know that the most important causes of cancer are the ones we can control. We are not cancers in the U.S. drink, too
always
at
the
mercy of our environment. Environmental pollution
accounts for only 2 percent of
DeWys
Dr. William
about 35 percent of
all
of the
all
cancer causes."
NCI
has estimated that diet causes
cancers, tobacco causes about
30 percent,
viruses about 5 percent, occupation about 4 percent, alcohol about
3 percent, excess sunshine about 3 percent, environmental pollution about 2 percent, medicine
percent and food additives,
To
fully
understand
help overcome the question,
it
we must
"What
is
1
how
and medical procedures about
percent or
less.
nutrients protect against cancer
start
with the
1
basics.
We
will
and
examine
cancer?" If you don't really understand
CANCER PREVENTION AND NUTRITIONAL THERAPIES
6
what cancer
is,
you probably won't be
able to understand
cancer can be prevented or cured. Cancer
or condition
—
a
it is
term used to describe over 100
monly known as "cancer." They are very enough to need slightly different approaches. tective measures are nearly identical;
to
it is
how
not just one disease
is
diseases
com-
similar, yet different
Fortunately, the pro-
the treatments that need
be individualized.
We
continue to learn about cancer.
the roles of
tumor
cancer formation.
initiators
We
We
understand more about
and promoters in the mechanisms of
are learning
more about how
cancers spread.
This knowledge will lead to drugs that will actually halt these processes.
However, we
vent these processes, and
of cancer and help the
We
already know that certain nutrients prewe know how they prevent the initiation immune system destroy existing cancers.
don't have to understand every
order to take
detail in
last
advantage of them. Earlier,
I
mentioned
individualized. Let
me
that
it
is
the treatments that have to be
be clear that nutritional therapy
is
compati-
ble with any other therapy. Cancer Prevention and Nutritional Therapies I
is
not intended to be used
don't say that
as a
practicing medicine.
but the reason
been
that
it
is
I
as a substitute for
disclaimer to prevent I
am
make
is
that
being sued for
not a physician,
a research biochemist,
the statement
other therapies.
me from
my
experience has
better to take the best of both worlds than to use
Of
good treatments and very make the point right at the start that this book is intended to protect you from cancer via the intelligent use of nutrients, and to help you overcome cancer if you already have it. This book is not intended to encourage you to try to treat either
one alone.
bad treatments.
I
course, there are
want
to
cancer with nutrition alone. If
you
are
wondering
how
nutrition can aid conventional che-
motherapy, surgery and radiation techniques, the
immune
system.
The immune system
is
it's
our
by strengthening
last line
of defense
overcome existing cancer. But, this book will show you more than just how to revive and strengthen your immune system; it will show you how to protect yourself with earlier that can actually
lines
of defense against the factors that cause cancer.
THE SCOPE OF THIS BOOK our bodies are always at war with cancer. It's a constant and we have many defenses. My aim is to not only make you aware of how you can strengthen your existing defenses, but In
fact,
battle
to
show you how you can add
will frequently discuss
quired,
how
to
how
The information Therapies can help
is
liver so that
a it
And even
cells.
how
to help
itself
and even counterattack.
good offense, you will learn how to can more effectively destroy invading
—
You
will also learn
how
to fortify
line of defense the membranes that are the skin of which keep cancer-causing agents from entering the
your second cell,
battles re-
presented in Cancer Prevention and Nutritional
chemicals that can cause cancer.
every
number of
that has already occurred.
your body defend
Since the best defense
your
your armamentarium. This book
improve your personal defenses and
your body repair any damage
activate
to
to reduce the
if these
agents penetrate the
ents will prevent the harmful reactions
cell,
antioxidant nutri-
from occurring by destroy-
ing free radicals required to actually do the damage. These same
body in repairing damage and in strengthening the immune system, which can recognize and destroy cancer cells. We'll also look at how the "war on cancer" in general is going. I'll get to the "how" to protect yourself and what to do if you have cancer later, but by now you are probably wondering a little nutrients aid the
about
my
that
can reduce your
I
experience with cancer research and risk
why
of cancer by 90 percent.
I
am
so sure
CHAPTER
2
My Research
My
research led
of those
me to who
scientists
cancer research in 1970.
Now
I
wasn't one
instantly converted their research to cancer
were made available with President Nixon's "war on cancer." It seemed that, with the signing of the "Conquest of Cancer Act" in 1971, every scientist who was working in a related field all of a sudden redefined his or her research because of the funds that
research in terms of cancer to take advantage of the source.
Of
course,
scientists into
it
was the intent of the Act
to
new
funding
draw more
cancer research.
None of my
research has ever been funded by the government, announced my success in extending the lifespans of laboratory animals by using a combination of antioxidant nutrients at the 1970 annual meeting of the Gerontological Society in Toronto. My research focused on stopping the deleterious effects in the body of very reactive chemicals called "free radicals." Today, the free-radical theory of aging is one of the most promising approaches to slowing the ravages of aging. In the 1960s there were very few of us working on this theory, which was developed by
however.
I
1
Dr.
Denham Harman
radicals cause
cancer
in the 1950s.
2
We
will
look
at
how
free
later.
At the gerontological meeting, another
scientist
wondered
if
my
success in extending the lifespan of the laboratory animals could
be due to
a
reduction in diseases such
slowing of the aging process. That 8
as
cancer, rather than a
comment
struck a chord, as
I
MY RESEARCH could
no apparent cancers
recall
9
in the antioxidant-protected ani-
mals, whereas the control groups receiving
normal
seemed
diets
to
have occasional cancers.
When
returned to
I
my
laboratory,
lifespans
I
designed a
was
to determine if cancer prevention
of the antioxidant-protected animals. As
of studies
series
improved
a factor in the it
turns out, the
antioxidant nutrients protect against cancer and also protect against
many
secondary events that
do not have evidence of aging,
if there
is
At
this time,
still
I
that the antioxidants affect the primary cause
one.
are involved in over
affect the lifespan.
now we know
However,
60 human
diseases,
and
that free radicals
that antioxidants
can
protect against the development of these diseases.
As
I
said, at this
time there were few researchers looking
detrimental role of free radicals in the body. Dr.
at
the
Denham Harman
of the University of Nebraska School of Medicine was investigating
on
the roles of single nutrients
the lifespans of laboratory animals.
Independently, Dr. Al Tappel of the University of California
Davis and
were studying combinations of antioxidant
I
at
nutrients.
Dr. Tappel was studying tissue levels of markers of free-radical
damage such
as lipofuscin,
and
I
was studying
actual longevity. Dr.
Gerhard Schrauzer of the University of California
at
San Diego
and Dr. Ray Shamberger of the Cleveland Clinic were studying possible epidemiological link
a
between selenium deficiency and can-
cer incidence. Dr. William Pryor of Louisiana State University and
Dr. Lester Packer of the University of California
at
Berkeley were
studying free-radical mechanisms. There were a few others close to this area
of research, but
towards what diet
now
this
the group that was progressing
is
has been confirmed as the major link
between
and cancer.
In those days, to mention that cancer was linked to diet was
blasphemous. quackery. still
Of
To
say that vitamins could protect against cancer
course, there are a
are not convinced, but
of the evidence and
now
most
few people around today
scientists
and physicians are aware
support the concept of protecting yourself
from most cancers with antioxidant that these
was
who
nutrients. Later,
we
same nutrients stimulate the immune system
discovered to help the
CANCER PREVENTION AND NUTRITIONAL THERAPIES
10
body overcome existing cancer in cases where the immune system hasn't been severely damaged by other treatments. Also in those days, most research was directed towards proving
how
caused cancer and developing vaccines to protect
viruses
With
against cancer.
war on cancer entrenching the
the
bureaucracy,
it
was
difficult to
plore this
new
In 1972,
who
line
cancer
turn the research effort around from
virus-vaccine to diet-prevention.
brave researchers
leaders of
new
the virus philosophy into leadership position in the
took two decades and many
It
risked funding and peer acceptance to ex-
of research.
filed for international patent protection for various
I
combinations of nutrients that protected against cancer. These patents
were granted
many
in
countries, but in the U.S., 3
motion machine. I Food and Drug Administration for a new drug
trying to patent a perpetual
it
was
like
also applied to the
application to test
the preventive powers of these antioxidant nutrients, but they de-
we
nied permission because that these nutrients
felt
In
May
Laboratory
1973,
I
published "Cancer:
and began
4
skeptical, as they didn't
Of course, know
of free-radical pathology. In
my
cals.
5
research in 1971,
Now free
among
on
a
protocol and they
safe.
New Directions"
in American
a lecture series to challenge other researchers
to join in the research.
on
couldn't agree
had not been proved
radicals
at that
very
time most
much
about
fact, until Prevention
scientists
this
new
were
concept
magazine reported
few people had even heard of
and antioxidant nutrients
are
free radi-
"buzz words"
goaded skeptical scientists into I was wrong. Eventually, many laboratory were published confirming the protective role of
the health minded. So
I
trying to prove that
animal studies
antioxidant nutrients. In 1975, trition:
I
published the results of my cancer research in Supernu-
Megavitamin Revolution. 6
By
1978, there was enough evi-
dence based on animal studies to publish the and
Its
Nutritional Therapies.
which showed erals
7
At
that time
that the deficiencies
I
first
edition of Cancer
cited hundreds of studies
of certain vitamins and/or min-
increased the occurrence of both spontaneous and induced
cancers. Conversely,
many
studies
showed
a
dose-dependent
tionship of nutrients to lowering the incidence of
many
rela-
cancers.
MY RESEARCH That
is,
more of
the
reduction in cancer
a nutrient that
rates.
consumed, the greater the
is
This, too,
1
was shown
for spontaneous
and induced cancers. In 1978,
I
could also
who
Those
nutrients in the diet.
C
nutrients such as vitamins A,
had more cancers than those
On
July 29, 1981,
Cancer
few epidemiological
cite a
was inversely
that cancer incidence
my
showing
studies
amount of certain foods with low amounts of
related to the ate
or E, or the trace mineral selenium,
who
ate
more ample amounts.
research was presented to the National
(NCI). Attending the meeting were Dr. William
Institute
Terry, Director of the
NCI
Division of Resources; Dr. John
Mac-
Donald, head of the NCI's Cancer Therapy Evaluation Program; Dr. Louis Carrese, Office of Program Planning and Analysis under
NCI
Adamson, DirecNCI; Dr. Michael Sporn, Laboratory of Cancer Prevention; Dr. Mary Ann Sestili, Executive Secretary, NCI; Dr. Mitchel Heft, National Institute on tor,
Director, Dr. Vincent DeVita; Dr. Richard
Division of Cancer Cause and Prevention,
Aging; Dr. Frank Rauscher, Vice President of Research, American
Cancer Society; and others. They wanted more animal studies, more autopsies, and more development of the theory before they would agree to support my research. Fortunately in 1981, there were a series of epidemiological studies
published that confirmed the protective roles of these nutrients
in real people, not just in laboratory animals.
demiologists
lost
sight
However,
these epi-
of the laboratory animal research and
thought that their research was standing alone. The two research strengthen each other and
my
goal
now
is
to
lines
show
of the
epidemiologists the laboratory animal research and vice versa.
Maybe some good research to the
did come out of NCI. By 1982, the NCI
the presentation of started a series
my
of work-
shops to introduce the "free-radical cause of cancer" line of research to scientists and began funding small "pilot" studies. In June
1982, the National
Academy of
entitled "Diet, Nutrition
burgeoning
line
Sciences published
a
pamphlet
and Cancer." This booklet discussed the
of evidence showing that certain nutrients could
be protective, and that people should include more foods with
.
CANCER PREVENTION AND NUTRITIONAL THERAPIES
12 fiber,
vitamins A, C,
E and
the trace mineral selenium in their
diets.
Fortunately, the strength of the research
prod the
NCI
became
sufficient to
into funding dozens of large-scale clinical studies
by
the end of the 1980s to provide the conclusive evidence.
What
is
of interest to you
is
that
my
research has withstood the
community. Also, what you do not have to rely on what I say, but as you will see throughout this book, you can rely on the evidence developed by hundreds of researchers who confirm what test
is
of time and
of
scrutiny of the scientific
you
interest to
is
that
say. And there are thousands of people out there who have told me how the information in the earlier editions helped them, and am grateful for all of their "God Blesses." This is why write I
I
I
this it
book. Please read
it,
check the research yourself, and
with your health care provider.
Now, see
And may God
bless
discuss
you, too.
check on the progress of the "war on cancer," and
let's
what we can do about
it.
References 1
Plans for a large-scale study of possible retardation of the process. 23rd
human
aging
Annual Meeting of the Gerontological Society, Toronto
(October 21-24, 1970). Also see Gerontologist (1970) 10(3):11, 28. 2.
The
free-radical theory
tology (1956)
of aging. Harman, Denham. Journal of Geron-
11:298-300.
4.
US 39140 and others, US 97011 and others Richard A. Passwater,"Cancer: New Directions," American Laboratory
5.
Don't age too
6.
Richard A.
3.
(1973) 5(6):10-22.
York: Dial 7.
fast.
Prevention (Dec. 1971) 23(12):104-10.
Passwater,
Supernutrition:
Megavitamin
revolution
(New
Press, 1975).
Richard A. Passwater, Cancer and
Its
Nutritional Therapies.
naan, Conn.: Keats Publishing, Inc., 1978).
(New Ca-
CHAPTER
3
Waging War on Cancer
The formal "War on Cancer" began with the National Cancer Act of 1971 passed by Congress and signed into law by President Richard Nixon on December 23, 1971. It was intended to be a "Christmas present" to the nation. The research community didn't consider this the best approach, but the public felt
better
by throwing more money
at
and
the problem.
really
politicians
The
feats
of
Program were based on knowledge. The mechanisms of cancer
the Manhattan Project and the Apollo already existing scientific are
still
not well understood.
Unfortunately, the additional tions.
It
money was
not spent in
new
direc-
was channeled into more of the same research because at the time were promoted
those supporting the popular research
to direct this beefed-up program. Thus, they funneled the
into the
same channels
that got
The National Cancer
them
Institute's
to their respected positions.
(NCI) budget soared from $180
million in 1971 to $400 million in 1972.
and 20 years were spent before
a
money
new
More
breed of
than $22 billion scientists
would
So many people believed that with so many "promising" new drugs and treatments that a cure was in reach. A popular theme was "Cure convince the agency of the value of prevention via
diet.
cancer by America's 200th birthday in 1976."
Twenty
years later,
than $2 billion,
with cancer.
and with an annual NCI budget of more 1.1 million Americans were diagnosed
more than
One
out of three living Americans could expect to 13
CANCER PREVENTION AND NUTRITIONAL THERAPIES
14
get cancer in his or her lifetime,
would not
cancer that year rate
from cancer
1991: 514,000 Americans)
(in
deaths in battle from
all
Worldwide cancer of the
who
and half of those
The
survive five years.
is
developed
annual death
nearing the
total
U.S. wars (578,245).
rates are also increasing.
About
2.3 million
million deaths that occur annually in industrialized na-
1 1
tions are caused
cancer rate for
by cancer.
men
When
lung cancer
excluded, the
is
in industrialized nations has increased
percent since 1950. Dr. Devra Davis of the National Sciences points out that the cancer rate
by 9
Academy of
increasing above and
is
beyond what we would expect due to aging or smoking. In 1982, the war on cancer goal was changed to "a 50 percent reduction in cancer-related mortality on an age-adjusted basis by the year 2000." By 1982, the 20-year trend showed that the annual number of deaths due to cancer had increased by 55.7 percent. In 1962, 278,562 Americans died from cancer. In 1982, the number was 433,795. The incidence of cancer increased 25.1 percent, but after adjusting for age the increase was "only" 8.5 percent. The absolute cancer death rate per 100,000 persons increased 25.1 per-
cent between 1962 and 1982,
which when adjusted
for age
is
8.7
percent.
The
researcher
who
published
this
comparison, Dr. John Bailar of
the Harvard School of Public Health, concluded:
emphasis, from research
on treatment
to research
necessary if substantial progress against cancer Just
how
to accomplish that goal
is
research
to be forthcoming."
show an
age-adjusted
of 14.5 percent, with age-adjusted death
increasing 5.4 percent.
by women,
shift in
Much
1
the subject of this book.
Later figures, comparing 1973 with 1987, in cancer incidence
is
"A
on prevention, seems
of that increase
is
attributed to
rise
rates
smoking
by 500 percent. The death rate from cancer rose 0.2 percent from 1988 to 1989, while the death rate from heart disease fell 6 percent and the overall death rate
A
as their
fell
report
lung cancer
rate increased
2.3 percent.
published
by the American Hospital Association,
"Meditrends 1991-1992," predicts that the number of people having cancer will double in the 1990s,
making oncology
cardiology the leading specialty in the U.S. Cancer
is
instead of
already the
WAGING WAR ON CANCER leading cause of death in
women, but
15
the report predicts that
by
the year 2000, cancer will surpass heart disease as the leading cause
of death for everyone. Dr. John Cairns, also of the Harvard School of Public Health,
1985 that there have been no significant gains in survival from any of the major cancers since the 1950s. The so-called improvements in survival rates are merely artifacts of the increased lead time due to earlier detection methods. By 1991, the men's lung cancer rate was on the decline, but aside from that there still wasn't much to brag about. The American Cancer Society had revised its estimate of a woman's lifetime risk of breast cancer from one-in-ten to one-in-nine. By 1991, the NCI had spent over a billion dollars on breast cancer alone. According to NCI figures, 26.9 women out of every 100,000 died of breast cancer in 1973; by 1988, the number had grown to 27.5 per 100,000. The Government Accounting Office reported to Congress in 1991 that from 1976 to 1983, the fiveyear survival rate for breast cancer increased 74 to 77 percent. Importantly, changes in surgery and the management of the disease have improved the quality of life for breast cancer patients. Critics point to the large expenditures and insignificant progress. They stress that new directions are needed. That was my theme in 1973. NCI supporters counter the criticism no matter what year we are talking about with glowing descriptions of how great stated in
—
—
the latest developments just entering the experimental stages are. It is
unfortunate that they haven't panned out so
far,
but maybe
many cancer made in cancer
the next one will be significant. In the meantime, researchers have discovered that great gains can be
prevention with antioxidant nutrients.
An ounce
of prevention
is
worth more than a pound of unsuccessful cure. Ralph Moss, former public affairs director at Memorial SloanKettering Cancer Center in New York, writes in The Cancer Industry (New York: Paragon House, 1989):
"Our country to
be
losing.
.
is .
.
waging
a billion-dollar
Conventional
treatments are often
more
surgical,
war on cancer, and we seem radiation and chemotherapy
devastating to the patient than the disease
CANCER PREVENTION AND NUTRITIONAL THERAPIES
16 itself
.
grabs
.
all
seem
the cards
With
selfishness.
and treatment money patients
marked by
the cancer field continues to be
.
and economic
.
.
there
.
to be the losers
.
.
is .
—money, power, — continuing
of
billions
political
power
dollars in research
fierce competition.
.
.
.
Cancer
while orthodoxy appears to have
prestigious credentials, influence in
the major media
the
failure
of orthodox medicine to
deal satisfactorily with the major forms of cancer guarantees the
growth of nonconventional approaches."
However, other such
not involved in the "cancer industry"
scientists
academic epidemiologists, are aware of the shortcomings
as
of orthodoxy and they are
also
aware of the role of
venting cancer. Several epidemiologists have
bring the message of prevention to the establishment.
on
their efforts in the chapters describing
diet in pre-
become
how
I
activists
to
will report
nutrients protect
against cancer.
Keep storm
in
mind
over.
is
that things often are the darkest just before the
There
is
good news
The
cancer, for example.
to report
on
the rarer forms of
five-year survival rate for children with
leukemia has increased from 5 percent in the 1950s to 65 percent
Hodgkin's disease was almost always and was almost always cured by the 1990s.
in 1981.
Survival rates have
improved
fatal
before the 1960s
significantly for testicular cancer,
bladder cancer, colorectal cancer, prostrate cancer and stomach cancer.
Not
of the improvement
all
is
accounted for by increased
lead time of early detection.
Lung cancer
in
men
can be prevented you. Let's look
your
risk
as
at
is
on
the decline.
well by diet and
some of
The
lifestyle
other major cancers changes.
It's
up
to
the lifestyle changes that can reduce
of cancer.
References 1.
John C.
Bailar
and Elaine M. Smith, "Progress Against Cancer?"
England Journal of Medicine (1986) 314:1226-32.
New
CHAPTER
4
Changes Prevent Most Cancers
Lifestyle
I
have already criticized the war on cancer for spending too
money on
old ideas and not enough
A
money on new
much
directions for
not enough what they can easily do to reduce their risks. I am not advocating spending more money -just spending it in ways that result in saving more lives. A group of 67 physicians and scientists under the auspices of Food and Water, Inc. held a news conference in February 1992 calling for Congress to insist that the National Cancer Institute spend more money on cancer prevention. Dr. Samuel Epstein of cancer research.
money
is
spent
second major criticism
on educating
is
that
the public about
—
the University of Illinois said:
"Americans
eat,
breathe and
work with
because the government concentrates too treating the disease
cancer-causing substances
much on
and not enough on preventing
it.
diagnosing and .
.
.
The
cancer
establishment has minimized the evidence for increasing cancer rates
which it has largely attributed to smoking and dietary fat, at the same time it has discounted or ignored the casual role of avoidable exposures to industrial carcinogens in the
air,
food, water and the
workplace."
A the
year
earlier,
Dr. Epstein claimed that
war on cancer 17
much of
the
money
in
CANCER PREVENTION AND NUTRITIONAL THERAPIES
18
"has been squandered on a has been done
fruitless
search for cancer 'cures.' Little
to prevent exposure to carcinogenic chemicals in
the environment, despite ample evidence that chemical pollution of
water, food, and the workplace
the major cause of cancer.
our
air,
On
the contrary, government, industry, and a small coterie of scien-
have combined to stymie
tists
such
sures, a
OK,
seems that
it
opinion that
we
We
up
It is
we
introduce preventive mea-
But cancer remains
to citizens to push for action."
have the "estabHshment"
soon have
will
have to worry about
and smoking.
efforts to
pollution control standards.
preventable disease.
their
we
as strict
is
is
1
scientists
significant treatments
avoiding dietary
fat,
with
and
all
excess sunshine,
have another, but smaller, group thinking that
on treatments and we have to worry more about pollutant chemicals. These two groups have been debating for years, but both should be paying more attention to our
we
spend too
who
scientists
much
effort
have a significant message about the role of antioxi-
dant nutrients in preventing cancer. Antioxidants protect against etary fat, smoking, excess
sun and chemical pollutants. They
response to other treatments by stimulating the
Before
we
get into the
new
immune
research that shows
nutrients protect against cancer,
let's
also
response.
how
antioxidant
review the ways in which
three groups agree that people can reduce their risks
all
by simple
changes.
lifestyle
All three groups generally agree is
di-
improve
on the
following, although there
debate on the amounts or degree:
1.
Don't smoke or chew tobacco. Tobacco, alone or in combination with alcohol, remains the most important cause of cancer, accounting for about
one in every three cancer
cases
occurring in the U.S. today. Limit exposure to secondhand
smoke.
(If
you
must
smoke,
antioxidants
offer
some
protection.) 2.
As
far as dietary guidelines go,
the key words are
tion" and "fruits and vegetables." In general: •
Maintain desirable body weight
•
Eat a varied diet
"modera-
LIFESTYLE
CHANGES PREVENT MOST CANCERS
19
•
Eat five servings daily of vegetables and
•
Eat foods rich in beta-carotene, vitamin A, vitamin C, vita-
•
Eat
•
Reduce
•
Limit alcohol consumption or don't drink alcohol
•
Limit consumption of salt-cured, smoked or nitrate-pre-
fruits
min E and selenium amounts
ample
whole-grain
cereals,
of fiber-containing foods legumes, vegetables and
total dietary fat to
30 percent or
such
as
fruits
less
at all
served foods. 3.
Limit exposure to sunlight.
4.
Exercise or keep active.
5.
Avoid heavy exposure
6.
Limit exposure to electromagnetic
7.
Check your home radon
8.
Get regular screening
to industrial
and fields
agricultural toxins.
and X-rays.
level.
tests as
advised for your age.
According to the establishment group, of each million cer cases, diet
is
new
can-
related to about 350,000; tobacco causes about
300,000; viruses, about 50,000; occupational exposure to chemicals,
about 40,000; alcohol, about 30,000; excess sunshine, about environmental pollution,
30,000;
about 20,000;
medicine and
medical procedures, about 10,000; and food additives, 10,000 or less.
The second group
many more cancers are caused by when you consider that most Ameri-
feels that
various pollutants. Actually,
cans are not adequately protected by nutritional antioxidants, the true figure for "diet"
You
is
700,000 to 800,000 or 70 to 80 percent.
don't have to worry so
much
about the "causes"
are adequately protected with nutritional antioxidants. If
genetically
if
you
you are
normal and follow the above advice, and optimally
nourish yourself with the antioxidants, your
total risk
is
decreased
by 90 percent.
Now
let's
look
how
at
each type of cancer.
the establishment applies this advice to
The following
and what the establishment believes a little
over
a million
table is
shows the type of cancer
each type's major cause for
2 cancer cases in the U.S. in 1990.
CANCER PREVENTION AND NUTRITIONAL THERAPIES
20
Number
Percentage
Lung
157,000
16
tobacco
Colorectal
155,000
16
low-fiber, high-fat diet
Breast
150,900
15
ovarian hormones
Prostate
106,000
11
testosterone
Bladder
49,000
5
tobacco
Non-Hodgkin's
35,600
4
(HIV,
33,000
3
estrogen
30,500
3
tobacco, alcohol
Pancreatic
28,100
3
tobacco
Leukemia
27,800
3
X-rays
Melanoma
27,600
3
sunburn
Kidney
24,000
2
tobacco
Stomach
Cancer
Major Cause
HTLV-1)
lymphoma Uterine
&
Oral
pharyngeal
tobacco
23,200
2
salt,
Ovarian
20,500
2
ovulation
Brain, nervous system
15,600
2
trauma, X-rays
Cervical
13,500
1
(papillomaviruses)
Liver
13,100
1
alcohol, hepatitis virus
Laryngeal
12,300
1
tobacco, alcohol
12,100
1
(iodine excess?)
11,800
1
p
10,600
1
alcohol, tobacco
Thyroid Multiple
myeloma
Esophageal
Even though
there
may be
specific causes
of these cancers, the
antioxidant nutrients protect against cancer because they interfere
with
how
the cancers form and stimulate the
destroy any cancer
Thus,
it
is
cells that
immune
system to
do develop.
incorrect to say that a deficiency of these nutrients
"causes" cancer; rather, the deficiency allows the cancer to form
when something the
more of
else starts the process. Basically
the antioxidant nutrient that
is
(up to a point)
present in your body,
LIFESTYLE
the
less
CHANGES PREVENT MOST CANCERS
chance something has of starting
proved in animal
studies
In order to understand
need
to
know
a little
a cancer.
21
This has been
and confirmed by population
how
studies.
we how
the antioxidants prevent cancer,
about the cancer process.
cancers are started and how some agents promote the development of cancer.
You
—such
will see as
alcohol
References 1.
2.
Samuel S. Epstein, "Losing the war against cancer: who's to blame and what to do about it," Int. J. Health Serv. (1990) 20(1):53-71. Brian E. Henderson, Ronald K. Ross, and Malcom C. Pike, "Toward the
primary
254:1131-8.
prevention
of
cancer,"
Science
(22
Nov.
1991)
CHAPTER
5
What Causes Cancer?
There
really
is
no need
protect against cancer;
know how the antioxidant nutrients that we need to know is that they do.
to
all
Studies have already established this as fact. This chapter
tended to help you understand cancer
itself
and
how
it
is
in-
develops.
how-to information on how to protect yourself against cancer, and you have no desire to understand more about cancer itself, then there is no need to read If
you
are just seeking practical
this chapter.
The National Cancer group of
really a
Institute
diseases.
types of cancer, but they
There
all
are a
(NCI) explains
that cancer
is
more than 100 different disease of some of the body's are
cells.
Most
cancers involve tumors.
The NCI
explains
tumor produc-
tion as follows:
"Healthy
cells that
make up
the body's tissues grow, divide, and
replace themselves in an orderly way. This process keeps the in
good
to limit
repair.
and
Sometimes, however, normal
direct their growth.
without any order.
Too much
They
tissue
is
body
cells lose their ability
divide too rapidly and
grow
produced and tumors begin
Tumors can be either benign or malignant. "Benign tumors are not cancerous. They do not spread to other parts of the body and they are seldom a threat to life. Often, benign tumors can be removed by surgery, and they are not likely to to form.
return.
22
WHAT
CAUSES CANCER?
23
"Malignant tumors are cancerous. They can invade and destroy tissue and organs. Cancer cells also can spread, or metastasize,
nearby
to other parts
The
tumors."
go
astray
is
Whatever
astray?
of cancer.
a cause
When
Membrane damage the cell membrane
—which
that
tell is
the cell
What,
causes cell regulation to
Here are three common types of damage mechanism of cells:
sensor
1
operative words are ''unregulated growth of cells."
then, causes cells to
go
new
of the body, and form
when
chemical reacts with components of
a is
the "skin" of the cell
to divide for
damaged, then
cell
that alter the regulation
growth
—
the sensors
growth can be damaged. uncontrolled; that
is
is
the
If a start
of cancer.
DNA damage DNA—which components it
can
—
chemical that enters the
If a is
with
reacts
cell
the "factory" of the cell that can reproduce cell
DNA
the
can be damaged. If the
DNA
is
damaged,
wrong stuff or it can churn out more than is wrong stuff is produced, then the cell becomes "mutated." Mutated cells will grow quickly because they
make
the
needed. If the altered or
are not confined
out more
and
cell
by
quantities of similar
this results in
this
is
If the is
DNA
Some
immune
chemicals, either directly or indirectly,
system from functioning properly. Although
not direct damage to the
cell's
regulatory mechanism,
involves part of the overall regulation of cell growth.
major
roles
cells
immune
of the
and destroy them.
churns
forced to divide
uncontrolled tissue growth.
Immunosuppression inhibit the
cells.
material than needed, the cell
An
system
impaired
is
to recognize
immune
system
One
it still
of the
mutated
may
let
cells
mutated
develop into cancers.
Cancer development to learn
much more
opment of cancer.
A
is
not
a single-step process.
We
still
need
about the multiple steps involved in the develthird criticism of the
war on cancer approach
CANCER PREVENTION AND NUTRITIONAL THERAPIES
24 is
that too
cells
much
effort
is
devoted to random attempts to
with poisons, and not enough
effort
cancer
kill
devoted to understanding
the cancer development process.
In 1890,
process than
we had a better understanding of the tuberculosis we have in 1993 of the cancer process. Cancer is a
complex, multi-step process in which genetic alterations tion. Nonetheless,
development
One
that
as
cells
they progress to a
accumulate multiple
more malignant muta-
we recognize three distinct phases of cancer we can halt with antioxidant nutrients.
largely uncontrollable factor in cancer
genetic susceptibility.
Some of us have
become mutated. These
development
genes that cause
is
cells to
genes, called "oncogenes," often do
not express themselves sufficiently to cause cancer until they
become
activated
by certain agents including chemicals, radia-
Some cancers, such as small-cell lung many as six independent oncogenes to
tion and viruses.
may
require
as
cancer, trigger
them.
Carcinogens
Initiate
Cancer
Here is how our 1993 knowledge shapes our thinking. People born with genetic abnormalities may have varying numbers of the required six oncogenes lying dormant and ready for activation. An analogy is an electronic device that operates by batteries. If six batteries are needed, the device won't operate until all six batteries are in place. The presence of the required oncogenes is like having the battery compartment loaded with fresh batteries.
The device
still
switch
activated. If
all
won't
is
start
will not operate, though, until the
six
oncogenes are inherited, they still all six oncogenes are acti-
cancer development until
vated by outside agents.
Others
ment
who
inherit fewer
oncogenes will not
start
the develop-
process until sufficient normal genes are altered by
outside agent such as chemicals,
radiation or viruses.
some
In other
words, the switch can be activated but unless the battery compart-
ment
is
full,
nothing will happen. Eventually,
when
all
of the
WHAT required oncogenes
CAUSES CANCER?
25
then additional agents can activate them
exist,
to start the cancer process.
may develop
Thus, some people
cancer very easily and others
may never
get cancer even though they are exposed to heavy amounts of cancer-causing substances. Consider the fact that not every smoker gets lung cancer and that some nonsmokers do. The genetically perfect individual
dant nutrients
who
well-nourished with antioxi-
is
may never undergo enough
able to switch
genetic alterations to be
on the cancer development
who
hand, a person
inherits
all
process.
oncogenes
six
breathe relatively minor amounts of secondhand trial
On
the other
have to
will only
smoke or indus-
fumes to activate the process.
Some cancers require little genetic alteration while others require much alteration. Similarly, some cancers require little activation and others require quite
a bit
of activation by the cancer
initiation
process.
The damage
is
gens can damage either directly or
caused by agents critical
known
as carcinogens.
by generating
free radicals.
Some
chemicals, radiation or viruses.
Carcinogens
to another
other
chemicals
compound can
that
convert
may be
chemicals considered to be
carcinogenic actually do not cause cancer until the
them
Carcino-
of genes called proto-oncogenes,
parts
body converts
the true carcinogen. Sometimes
is
pre-carcinogen
a
into
a
true
carcinogen.
Your
best protection
is
to
not expose yourself to significant
amounts of any carcinogen or pre-carcinogen. Since complete avoidance of carcinogens is not possible, try to limit your exposure and protect yourself with antioxidant
nutrients.
They
will interfere
with the mechanism that carcinogens use to do their damage, and they also interfere with
many of
the processes that convert pre-
carcinogens into true carcinogens. I
described this process in
my
Directions," and this knowledge later.
2
prove
It's it.
just that
now we
1973
article,
"Cancer:
New
is still state-of-the-art 20 years have more convincing evidence to
CANCER PREVENTION AND NUTRITIONAL THERAPIES
26
Promotion Keep
mind
in
development process does not
that initiating the
produce
necessarily lead to cancer. This process alone will only
of independent precancerous
a series
cells.
The
process must be
propagated to the point where these precancerous
and develop
duce, associate system.
If there
is
own
their
no propagation or
cells will
repro-
blood supply and defense the
if
activated and destroys these precancerous
immune
cells,
system
is
then there will be
no cancer developed.
The next
step
cancer development,
in
called
"promotion,"
allows the precancerous cells to reproduce rapidly and change their
membrane cells.
surface properties to those characteristic of malignant
Anything
promotes
that
cell
reproduction
decreases
the
chance that repair enzymes will repair (deactivate) the activated
oncogene.
Compounds sion,
that increase cell reproduction (also called cell divi-
or mitosis) are
searchers
call
commonly
called "promoters."
Cancer
re-
them "epigenetic carcinogens." Many promotors
work by damaging growth
suppressor genes or by inactivating
components of the immune system. Common promoters include hormones and polyunsaturated fats. As an example, notice that smoking and drinking are cocarcinogens in esophageal cancer. Tobacco smoke components initiate the cancer by altering the DNA of the genes and then activating the altered genes. Alcohol becomes a factor because it promotes the development of cancer from the precancerous
alcohol,
cells.
Studies have
shown
that
even
a single
drinking binge can in-
crease the cancer incidence. Rats injected with cancer cells
and
then given alcohol to the point of intoxication developed twice the
number of tumors compared
Those who had blood
levels
to those not receiving alcohol.
of alcohol greater than 0.25 percent
had eight times more tumors. 3 It
appears
system's
as
"killer
bloodstream.
if
alcohol suppresses the ability of the
cells"
to
destroy
cancer
cells
traveling
immune in
the
WHAT
CAUSES CANCER?
27
Progression Even with promotion, the proliferating cells will not necessarily develop into cancer. The cell mass must grow large enough to affect body metabolism and start its own blood supply and defense system. This is where the immune system can do its job, unless it is
impaired. Also, sometimes the altered
they just die
The 1.
cells are so
defective that
off.
multi-step cancer process can be summarized as follows:
Initiation
Gene alteration Oncogene activation
a.
b. 2.
Promotion
3.
Progression
4.
Cancer (carcinoma, adenocarcinoma)
5.
Metastasis (spread to other areas)
It
is
important to note that antioxidant nutrients can protect
and every
against each
be protective against initiation stage,
ent that
is
some
step,
although the same nutrients
all steps,
Some
may
not
nutrients protect only at the
protect against promoters, and so on.
protective against one step
may have no
A nutri-
"special" use
at later stages.
A
specific antioxidant nutrient
cals to
may
protect by trapping free radi-
prevent the initiating damage, but
free radicals,
then
it
will
have no
if it
known
works only
to trap
value against existing
tumors. Such a nutrient must be in the diet well in advance of
developing
full-scale cancer.
However, many
free-radical trappers protect against several
cancer development steps. As an example, vitamin
E
traps free
works against existing cancers by stimulating the immune system. Even when the immune system doesn't completely overcome existing cancer on its own, a strong immune response often determines who is cured by a treatment and who isn't. Hopefully by now you are curious about free radicals, free radiradicals
and
it
also
CANCER PREVENTION AND NUTRITIONAL THERAPIES
28
cal reactions
This
is
and
how
antioxidant nutrients protect against them.
explained in the next chapter.
References know
1.
"What you need
2.
Richard A. Passwater, "Cancer:
to
about cancer."
NIH
Publication
88-1566
(1988).
New
directions." American Laboratory
(1973) 5(6):10-22. 3.
Gale Page,
Anaheim
et
al.
(1992).
(UCLA)
Society for Neuroscience Annual Meeting,
CHAPTER
6
The Battleground: Antioxidants Versus Free Radicals
If free radicals
chapter
and antioxidants are
may add
to
sary to understand
just
"buzz words" to you,
your understanding. However,
how
it is
this
not neces-
antioxidant nutrients protect against cancer
in order to take advantage of them. If
you
are interested, read this
chapter, otherwise skip ahead to chapter seven.
My for
research has centered around free radicals and antioxidants
more than 30
most of
my
years. It has always
for antioxidants to halt free radicals.
behind
how
been
result-oriented.
I
spend
time looking for better antioxidants and better ways
The
elucidation of the theory
antioxidants trap free radicals and
how
free radicals
can cause the damage that can lead to cancer has been done by others such as Dr. William Pryor of the University of Louisiana
and Dr. Lester Packer of the University of California
at
Berkeley.
Free Radicals Let's start
then
we
by defining
should
a free radical. If this
know something 29
about
it.
is
A
the culprit free radical
we
fear,
a
very
is
CANCER PREVENTION AND NUTRITIONAL THERAPIES
30
A
reactive chemical or chemical fragment.
free radical
is
defined
compound or part of a compound that has an "unpaired" electron. The concept of an unpaired electron confuses many peoa
as
who
ple
have had high school or college chemistry and are familiar
with the charged chemical fragments called "ions."
A
normal ion
—
a chemical fragment
is
either an atom, a molecule
more
or a part thereof, that by losing or gaining one or a net electrical charge.
ered an ion
but
also,
An
let's
The
be consid-
keep things simple and ignore them for the
The
purposes of this discussion. or negative.
electrons has
isolated electron or positron can
charge of an ion can be either positive
on
strength of the positive charge depends
num-
the
ber of missing electrons, and the strength of a negative charge depends
on to
the
number of
do with the
extra electrons in the fragment. This has nothing
directions
of spin of the
electrons.
number
In normal ions, the fragment always contains an even
of electrons, and these electrons are associated in opposite directions. If
from
this
somehow one of
normal arrangement, be
nonpaired electron
This
is left.
the electrons
in a
it
pairs that spin in is
removed
molecule or an ion,
Nature prefers molecules and ions to have paired electrons, is
a
lower energy
a free radical
is
few millionths of energy
state
then it
a second. This
a
nonpaired electron
is
because
The
it
is
not
at
When a
the lower
Therefore, the free radical
occurs.
By
another molecule, another free radical tions can
exists.
—normally tries
to
energy and grab an electron from another molecule.
where the damage
is
when
as this
usually doesn't last very long
that nature prefers.
dissipate this extra
That
state
created
a
a free radical.
is
is
grabbing
this
electron
from
These
reac-
usually created.
go on and on in destructive chain
reactions.
damage to cell components is much more severe would think possible from one small initiating free radical. You can visualize this by considering the initial free radical as a nail in the road, and the resulting damage as many cars resulting
than the damage one
involved in
Some
a
chain-reaction crash.
free radicals are
not
as
dangerous
as
others.
The harm
done by free radicals depends on their number, where they formed and the biological system involved. Carcinogens readily produce free
radicals
are
and the body normally
THE BATTLEGROUND: ANTIOXIDANTS VERSUS FREE RADICALS produces some free
radicals.
called superoxide during
oxygen molecule
to
Oxygen can be made
into a free radical
normal metabolism. Superoxide
which an
31
is
merely an
electron has been added. This electron
may be added in a variety of ways. A common way in which this may happen is when some reduced metal such as iron or copper
—
might donate an electron to oxygen, thereby making superoxide.
Superoxide free
radicals
can be converted into a hydroperoxide.
Hydroperoxides are not very reactive unless they are reduced by free iron or copper ions, in which case they are transformed into hydroxyl
radicals.
be produced
at
Hydroxyl
an enormous
radicals are quite reactive. rate
and they
They can
persist sufficiently
long
to damage cellular proteins, fats and DNA. Fats are easy to damage by oxygen-radical attack. Fats can become free radicals called lipid peroxides which can, in turn, damage proteins. Hydroxyl radicals, which can be formed from oxygen during metabolism, can directly damage cellular proteins. Free radicals can damage proteins in such a way that they are "cross-linked" together, which will impair their functional activity. Free radical cross-linking damage to DNA may impair its ability to open up to express genes. Enzyme function would also be impaired. The body has enzymes which can repair much of the damage to proteins, but when these enzymes become damaged themselves, repair processes are compromised. If a large number of free radicals are produced by an acute
exposure
to
carcinogens,
then
the
body's
antioxidant
defense
mechanisms may be overwhelmed. They will just simply not be able to cope with the load of free radicals, and this will initiate free radicals into crucial biological molecules, small molecules and macromolecules which can be propagated, leading to molecular damage, cross-linking and inactivation of functional
activity.
Antioxidant Defenses The body
defends
antioxidant nutrients radicals.
minor numbers of free radicals with and enzymes specifically designed to quench
itself against
These substances include vitamin A, vitamin C, vitamin
CANCER PREVENTION AND NUTRITIONAL THERAPIES
32 E,
coenzyme Q-10, beta-carotene and other
mineral selenium, and enzymes such thiol
carotenoids, the trace
glutathione peroxidase,
as
enzymes, hydroperoxidases and superoxide dismutase (SOD).
The
antioxidant nutrients quench free radicals by sacrificing
themselves. This stances that react
is what antioxidants do. Antioxidants are submore easily with oxygen than the substances that
they are intended to protect. In the process, the antioxidant nutrients
become
free radicals themselves.
One might that when the
ask,
what does one gain by
nutrients
become
this?
What one
gains
is
free radicals, they are less reactive,
longer-living radicals, and thus, not so dangerous to the biological system. Because they persist longer, the nutrient radicals can be
converted back to their normal, protective, antioxidant forms. net result
much of It
has
is
that the harmful free radicals
The
have been destroyed and
the antioxidant nutrients remain ready to protect again.
now been
established that
more than 60 human
diseases
involve free-radical damage, including cancer, heart disease and acceleration of the aging process. All that
you
really
need to know
your body is under constant free-radical attack, and you need to keep your antioxidant defenses strong. is
that
Carcinogens and pro-oxidants (such the need for antioxidants.
ready to look cancer.
at
With
as
fats
and
that
iron) increase
that basic understanding,
you
are
the evidence that antioxidants protect against
CHAPTER
Vitamin
7
A and
Beta-Carotene
In the next several chapters
I
will present the evidence that antioxi-
dant nutrients protect against cancer.
I
will also present
some fun-
damental information about the amounts needed to achieve protection.
It
may
order, but that
is
appear
as if
I
am
discussing
a coincidence. Actually,
I
them
am
this
in alphabetical
them
discussing
in
the order of their scientific interest.
This chapter will discuss vitamin carotene. Beta-carotene people, but
it is
body converts
is
simply the
still
and
and
a strange
name given
into vitamin A. Vitamin
ucts such as liver, milk
A
eggs,
precursor, beta-
sounding name to many
to the
A
its
is
compound
found
that the
in animal prod-
whereas beta-carotene and other
carotenoids are found in plant foods, primarily in yellow or orange vegetables, dark green leafy vegetables and
some
fruits.
Beta-Carotene and Other Carotenoids People have always been told that carrots are good for your eyes because they are rich in vitamin A. In vitamin A! Carrots do have
lots
reality,
carrots
have no
of beta-carotene and other carot-
enoids which are converted into vitamin 33
A
inside
our bodies. The
CANCER PREVENTION AND NUTRITIONAL THERAPIES
34
body has an enzyme that cleaves beta-carotene molecules in half to produce two vitamin A molecules. "Big deal," you say, "the difference is only a technicality." Wrong! The difference is significant. Beta-carotene and other carotenoids are nontoxic in the amounts that ordinarily can be consumed. Vitamin A, on the other hand, can be toxic in amounts that can be taken by the unaware. Another important difference
that the
is
blood
proportional to the dietary intake. fairly
contrast,
constant over normal levels of intake,
removed from the blood and stored There
another distinction that
is
A
There
cannot.
strengthen the
immune
is
as
Vitamin
may be
important. Beta-caro-
that
A
maximum
A
as
converting
they should
A
consumption of both vitamin
percent of the
RDA
A
and
protection.
Unfortunately, the U.S. Department of Agriculture surveys that
can
that beta-carotene
important to get both forms, vitamin
carotenoids, in the diet for
and
1
as efficient in
beta-carotene and other carotenoids into vitamin is
cells,
beta-carotene
function of cancer patients.
Conversely, there are actions of vitamin
it
remains
"extra" amounts are
which can damage
evidence
does not have. Also, some people are not
be. Therefore,
A
in the liver.
tene can neutralize "singlet oxygen,"
vitamin
of the carotenoids are
levels
By
(recommended
dietary
show
below 70 allowance, which
and carotenoids
is
doesn't even consider the extra need for cancer prevention) for 31
percent of Americans, and below 60 percent of the
RDA
for
23
percent of Americans. 2 3 Typical American diets contain about 1.5 '
milligrams of beta-carotene daily. to 6 milligrams daily,
grams
They should contain
at least
and be supplemented with 15 to 25
5
milli-
daily.
Beta-carotene
is
the best protector against cancer of the 20-
some carotenoids normally found
in food.
The next
best are alpha-
carotene, lycopene, lutein and canthaxanthin. All of these carotenoids, with the exception of lycopene, can be converted into
vitamin
There
know
if
A
in the body.
will always it
is
be some
the vitamin
other factors in
fruits
A
who
contend that
we
still
don't
or carotenoids that are protective, or
and vegetables
that are the true protective
VITAMIN A AND BETA-CAROTENE
There
factors.
is
no question
that vitamin
shown
tests in
which vitamin
A
and carotenoids them-
been demonstrated
selves protect against cancer. This has
tory animal
A
A
and other antioxidant
in labora-
and/or carotenoids alone have
a dose-related protection against cancer.
vitamin
35
I
have shown that
nutrients, alone,
have reduced
cancer incidence by over 90 percent. However, a study designed to elucidate the
answer to the question was published in 1991.
concluded that "the (main) cancer-protective factor rather than another
bles
not interpret
carotene,
component or combination of components of
vegetables and fruits."
Do
is
4
this
conclusion
as
saying that fruits and vegeta-
have no other cancer-preventing values. They contain
nutrients
and other compounds, including
moters, that offer
It
some protection
fiber
many
and enzyme pro-
against cancer.
The
point
is,
A and carotenoids themselves do protect against cancer, and you should take advantage of them. Eat your fruits and vegetables but also supplement your diet with appropriate amounts of vitamin
vitamin
A
and carotenoids
as
discussed at the end of this chapter.
Vitamin A's Protective Action
A
and beta-carotene first for two reasons; first, vitamin A has been associated with cancer prevention longer than any other nutrient, and second, because vitamin A is involved with cancer prevention in three ways. The evidence that vitamin A was protective against cancer first came to light shortly after its discovery in 1913 by McCollum and I
will discuss vitamin
Davis.
5
In the early 1920s
two
reports associated vitamin
ciency with cancer-like changes in trachea,
larynx
mucous
and bronchi. 6,7 Several
through the 1950s confirmed that vitamin
studies
A
A
defi-
tissue cells lining the
from the 1930s
functions in the main-
tenance of normal tissue and control of cellular growth, and that deficiency produces metaplastic changes.
By
the mid-1950s studies
were showing
that vitamin
A
regulates
the series of events in the development of the differences in types
of
cells.
Thus, the
first
way
in
which vitamin
A
(not the carot-
CANCER PREVENTION AND NUTRITIONAL THERAPIES
36
is involved in cancer prevention is through regulation of growth and development. This is greatly different from the second way (for both vitamin A and carotenoids), which is antioxi-
enoids)
cell
A
dant protection against free radicals. enoids and vitamin cells
A
third
way
is
that the carot-
both enhance the communication between
so that mutated cells cannot cause other mutated cells to grow.
This line of research examines the relationship between carotenoids
and synthesis of
a
"gap-junction" protein called connexin} Cells
can communicate with other
growth
factors that travel to
cells either
another
by having
a cell secrete
or by direct contact with
cell,
information exchanged across gap junctions.
The
regulation of growth and differentiation
in the early editions
of this book,
is
important
also
back to normal. As
in helping to return cancerous cells
as early as
I
reported
1974 researchers were
aware of the potential of vitamin A. Dr. Frank Chytill of Vanderbilt University was quoted
as saying,
"Recent dramatic findings about vitamin A and its effects on canopened up a whole new approach to cancer therapy." Dr. George Plotkin of the Massachusetts Institute of Technology was quoted as saying that "Vitamin A deficiency doesn't cause cancer, but it makes the body less able to resist cancer." He found cer have
that giving rats ten times their usual vitamin
A
intake dramatically
slashed their susceptibility to lung cancer.
Now
this
researchers
deficiency.
The
crossing over into the protective role of extra
amounts of vitamin A,
as
I
had found
in 1972.
9
1975, Norwegian researcher Dr. E. Bjelke did a study of
In
8,278 cer.
A
was no longer involving vitamin
now were
men and found
(Vitamin
A
itself
that carotenoids protected against lung can-
was not
studied.)
10
However, few
researchers
paid any attention to these findings. In a at
December 1977
discussion
I
had with Dr. Michael Sporn
the National Cancer Institute (NCI) he stressed:
"If
you
are vitamin A-deficient, there
is
no question
that
you may
be more susceptible to development of cancer. Probably one of your best investments that you can make in your food budget is to spend a few cents a day and take a multivitamin capsule. .
.
.
VITAMIN A AND BETA-CAROTENE "Well over half of
human
all
cancer
37
starts in epithelial tissue:
forms the lining of organs, forms glands such
tissue that
glands, skin,
and passages in the body. The respiratory and the reproductive
digestive tract, the urinary tract,
lined with epithelial tissue.
A
The approach
And
is
a
that
of the specialized
all
depend on vitamin
epithelial tissue
"Vitamin
as
A
for their
tract,
the
tract are all
form
cells that
normal development.
hormone-like controller of
we
the
mammary
are trying to develop
cell differentiation.
is
to use vitamin
A
derivatives, not to kill cancer cells, but to control the differentiation
of precancerous
What to
cells."
Dr. Sporn meant by "controlling
keep the
cells in a
mature differentiated
verting back to the undifferentiated
cell differentiation" state,
is
rather than re-
cells that are characteristic
of
cancer.
Dr. Sporn
is
an
NCI
pioneer in prevention of cancer. This
approach was almost unheard of in the mid-1970s. Dr. Sporn explains:
"If
you do
all
is
just
slow
down
process of development of
this
cancer so that instead of the typical twenty-year latent period from the time people
may be
first
that they develop cancer,
would be twenty
exposed to
you double
additional years of
a
carcinogen and the time
the latent period, then there
good
that
life
you would be
offering people.
"Now
in terms
of modern surgery and chemotherapy,
get an additional five years of survival, this
major achievement. So what
down
we
considered
do
is
they
a
very
to slow
or prevent the development of malignancy.
"If you slow
it
down enough,
then for practical purposes
occurs, although the basic process of still
is
are really trying to
if
be going on, but
at a very,
it
never
development of cancer may
very slow rate
—such
that
it
really
never causes anyone any problems.
"The
latent period
is
like a fire that
is
smoldering beneath the
no symptoms; but if one goes and looks for precanyou can find evidence of the chronic disease process. The object of the preventive approach as I see it is to do something
surface.
cerous
It
gives
cells,
about the disease process
when
it
is
in the early,
smoldering
stage,
CANCER PREVENTION AND NUTRITIONAL THERAPIES
38
you have the fire. Once you have invasive cancer, then you do prevention anymore. You have to change your approach. "It's pretty clear that vitamin A has hormone-like action in con-
before can't
trolling cell differentiation.
which the gene
radiation. Usually, the
damage
Cancer would appear
DNA,
material,
damage
has been
to
be
a disease in
damaged by chemicals or
will kill the cells, but
sometimes the
leads to cancer.
"Once
DNA
damaged, cancer doesn't occur immediately.
is
can be twenty years
after
DNA
It
damage occurs before malignancy
develops."
Conclusive Scientific Evidence In 1979, a study of 25,000 Japanese
showed
that beta-carotene
protected against cancers of the lung, stomach, colon, prostate and cervix.
11
However,
in spite
my
logical studies,
of the
many
animal studies, the few epidemio-
lectures, articles
and book on the
the pioneering interest of Dr. Sporn at in preventing cancer did
not arouse a lot of interest.
ered" the role of vitamin
drew
A
subject,
and
the role of nutrition
famous researchers in the cholesterol
internationally
reputations
NCI,
It
wasn't until
field
"discov-
in preventing cancer in 1981. Their
Who
interest to the field.
credit as long as the information
cares
who
gets the
disseminated so that the
gets
public can benefit?
The landmark paper was published by Dr. Jeremiah Stamler of Northwestern University School of Medicine and various colleagues at three other institutions. 12 This study followed 1,954
dle-aged
men
for 19 years.
four groups, depending on
they had in their
Men
It
midcompared the incidence of cancer in
how much
vitamin
A
and carotenoids
diet.
A intake had seven times compared with those in the top quartile. For 30-year smokers, the protection of vitamin A was even greater those in the lowest quartile had 8.1 times as much in the lowest quartile
of vitamin
the incidence of lung cancer
—
VITAMIN A AND BETA-CAROTENE
lung cancer
as
those in the top quartile of vitamin
39
A
The
intake.
following table summarizes the findings:
Vitamin
A
Intake
Relative
Quartile
All
Lung Cancer Risk
Men
Smokers
lowest
7.0
8.1
2nd
5.5
5.6
3rd
3.0
3.9
highest
1.0
1.0
Table 7.1 shows the three-dimensional graph of the
A
results, plot-
smoking and the incidence of lung cancer. Note that nonsmokers consuming the most vitamin A had no lung cancers. Also note that moderate smokers consuming more vitamin A had fewer lung cancers than nonting vitamin
intake against duration of
smokers receiving In 1982, the
little
vitamin A.
Committee on
Diet, Nutrition and
National Research Council, National its
report, "Diet, Nutrition
logical
evidence
vitamin
Now
A
is
Cancer of the
Academy of Sciences
and Cancer." 13
It
published
concluded, "Epidemio-
sufficient to suggest that foods rich in carotene or
are associated with a reduced risk
the floodgates of research
of cancer."
were opened. Many
researchers
took note and began publishing scores and scores of research
studies.
The picture is clear to most scientists working in the field: Vitamin A and carotenoids protect against many types of cancer. Many scientists are calling for the Food and Drug Administration (FDA) and the
Life Sciences
Research Office of the Federation of Ameri-
can Societies for Experimental Biology (FASEB) to look
new
studies
and to re-examine
However, unequivocal trials
in
humans.
It is
scientific
doubtful
at
many
their positions.
proof awaits prospective
if official
agencies will
clinical
recommend
A
and beta-carotene until the final evidence is in. These studies are under way, and the results should start coming in by the late 1990s. In the meantime, I advise you to supplements of vitamin
consider fortifying your diet with appropriate amounts of vitamin
A
and carotenoids.
Remember
the recommendations by the
NCI
.
CANCER PREVENTION AND NUTRITIONAL THERAPIES
40
and the American Cancer Society to
A
eat
more foods
rich in vitamin
and beta-carotene.
Prevention Dietary recommendations for vitamin
ducing your
1
risk
of cancer are
A
and carotenoids for
re-
as follows:
Eat a varied diet that includes five daily servings of
fruits
and
vegetables. 2.
To
A levels,
ensure adequate carotenoid and vitamin
consider
taking a daily vitamin supplement containing the following:
5,000 to 10,000
IU of vitamin A,
15 to 25 milligrams of
beta-carotene (25,000-42,000 IU). Formulas containing other carotenoids
may become
available in the future.
Therapy Vitamin
A
and the carotenoids can help any proven therapy known
at this writing, cells
because they stimulate the
mature into normal
Although
cells.
dietary cancer therapies stress fruits that are rich in the carotenoids,
mending such approaches ents along
The
I
alone.
immune several
system and help
of the unproven
and vegetables and
have no
My
their juices
scientific basis for
emphasis
is
recom-
to use these nutri-
with conventional therapies.
levels
of vitamin
A
and carotenoids
listed for
prevention
should also serve well for adjunct therapy, unless directed otherwise
by your health care
professional.
References 1.
George
S.
Hughes, "The
effects
of beta-carotene on the
system in cancer," Nutr. Rep. (1992) 10(l):l-8.
immune
VITAMIN A AND BETA-CAROTENE 2.
M. Pao and
E.
States," 3.
A.
S.
41
Mickle, "Problem nutrients in the United
J.
Food Techn. (1981) 35:58-79.
Grocetti and H. A. Guthrie, "Nutrient quality of diets of
F.
respondents from nationwide food consumption survey, 1977-78,"
USDA 4.
R.
Conference, Washington, D.C., (Nov. 1982).
Harris, et
"A
al.,
case-controlled study of dietary carotene in
with lung cancer and in
men
with other
men
epithelial cancers," Nutrition
and Cancer (1991) 15:63-8. 5. E. V.
the
McCollum and M.
diet
during
Davis,
"The
growth," Journal
necessity of certain lipids in
Chemistry
of Biological
(1913)
15:167-75. 6.
S.
Mori, "The changes in the para-ocular glands
vitamin
(in
A
defi-
cient diets)," Johns Hopkins Bulletin (1922) 33:357-9. 7.
S.
B.
Wolbach and
tion of fat-soluble
P.
A
R. Howe, "Tissue changes following depriva-
vitamin," Journal of Experimental Medicine (1925)
42:753-77. 8.
George Wolf, "Retinoids and carotenoids as inhibitors of carcinoand inducers of cell-cell communication," Nutrition Reviews
genesis
(1992) 50(9):270-4. 9.
Patent application
US
39140,
10. E. Bjelke, "Dietary vitamin
A
US
97011 and
others.
and lung cancer,"
International Journal
of Cancer (1975) 15:561-5. 11.
T. Hirayama, "Diet and cancer," Nutr. Cancer (1979) 1:67-81.
12.
Pachard B. Shekelle
et
al.,
"Dietary vitamin
A
and
risk
of cancer in
the Western Electric Study," Lancet (Nov. 28, 1981) 2:1185-90. 13.
Committee on
Diet, Nutrition and Cancer, National
Academy of
Sciences, Diet, Nutrition and Cancer (Washington, D.C.: National
Academy
Press, 1982).
CHAPTER
8
Vitamin C Against Cancer
In the
summer of 1990, I had difficulty believing that what I was The National Cancer Institute was cosponsoring
hearing was true. a
symposium
to
examine the biologic functions of vitamin
possible relation to cancer. Scientists at the
C
and
its
NCI's Division of Cancer
Prevention and Control were so impressed by the over one-
hundred epidemiological
studies
showing
against cancer that they invited over
that vitamin
130
scientists
C
protected
from around
the world to discuss the topic September 10th through the 12th, in 1990.
counting
They even his
invited Dr. Linus Pauling, after years of dis-
work. The two-time Nobel Laureate had the
last
laugh.
One summary
of this historic conference
tinues to accumulate that vitamin
C
has
stated,
"Evidence con-
numerous biologic
effects,
some that may relate to the prevention of cancer." Another summary noted that "the data caused many participants to 1
including
reconsider the importance of this agent in physiologic and clinical events."
At
2
this
landmark conference, the action of vitamin was discussed, along with the way in which
free radicals
C
against
this
action
prevents cancer. Several studies described the role of vitamin
C
in
function. Vitamin C can concentrate in neutrophils and lymphocytes to supercharge them against viruses, bacteria and damaged cells.
immune
Researchers reviewed
many of the 42
laboratory animal studies that
VITAMIN C AGAINST CANCER
showed vitamin
C
43
reduced cancer incidence. Out of the 75 epide-
miological studies that were reviewed, 54 unequivocally strated "significant evidence
with
a
of a reduced
demon-
risk for cancers in
persons
higher intake of vitamin C." 3
Conference members even discussed the "several studies [which] that vitamin C enhanced the effectiveness or reduced the
found
toxicity of traditional cancer therapies."
been
my
Later,
theme since 1973, and are the newspaper headlines informed
intake resulted in longer finally
life.
4
It
funding studies on vitamin
Cancer and
Its
1976
funding.
Even Dr. Linus
that vitamin 5
is
C
Well, these findings have subject of this book. us that high vitamin
C
When
Pauling,
I
first
C
NCI
so exciting to see the
and cancer.
Nutritional Therapies, absolutely
spent in this area. in
2
wrote
no funds were being
who
had presented data
benefited cancer patients, couldn't get
Anyone who wanted
had from
to investigate this area either
to use their personal funds or bootleg the research with funds
other projects.
Even before the NCI conference on vitamin C, the U.S. Surgeon General concluded that human studies did show a protective association between foods containing vitamin C and cancers of the 6 esophagus, stomach and cervix. The National Research Council's "Diet and Health Report" concluded that epidemiological studies did suggest that vitamin C-containing foods such
and vegetables may
offer protection against cancer.
In February 1992, Dr. Gladys Block the
NCI to
citrus fruits
(who had relocated from upon
to the University of California at Berkeley) called
other scientists to petition the
(FDA)
as 7
Food and Drug Administration
consider allowing the information about vitamin C's
protective action against heart disease to be given the status of an official
health claim. She pointed out that although every study
was not the ultimate
in scientific design (none are), the preponder-
ance of evidence suggested that vitamin
C
and the other antioxi-
dant nutrients are protective against cancer.
Dr. Block stated in her letter to other scientists
"I
have reviewed the epidemiologic
literature,
that:
about 140
studies,
on the relationship between antioxidant micronutrients or their food
CANCER PREVENTION AND NUTRITIONAL THERAPIES
44
sources and cancer
With
risk.
The
data are overwhelmingly consistent.
possibly fewer than five exceptions, every single study
the protective direction, and something like
found
statistically significant
reduced
risk
is
in
110 to 120 studies
with high intake."
The Roles of Vitamin C Against Cancer I
have already discussed the role of vitamin
nutrient that traps free radicals. are the reactions that vitamin
but the reactions that vitamin
Recently
we
C C
C
as
does more than
It
is is
directly
an antioxidant that.
Not only
involved in important,
indirectly
involved in
as well.
have begun to understand two additional functions
of vitamin C. These functions were reviewed by Dr. Harish Padh of the University of Chicago. 8
The first new realization involves vitamin Not only is vitamin C an antioxidant
dant.
body components by scavenging antioxidant in the sense that
enzymes
in their proper
Minerals such
as
it
C's role in terms
free radicals,
as
an antioxi-
of protecting
but vitamin
C
is
an
keeps the mineral portions of certain
reduced electronic
state.
iron and copper are key components of hun-
dreds of enzymes. This includes copper in monooxygenases and iron in dioxygenases.
Enzymes control body
chemistry.
Nearly
every type of reaction in the body requires a specific enzyme.
Enzymes
that
depend on iron and copper won't work
minerals are oxidized to a higher electronic valance
C
restores this required electronic state
state.
if these
Vitamin
and thus rejuvenates oxi-
dized enzymes.
Dr. Padh concludes,
most
significant role
"The
available data suggest that perhaps the
of ascorbate
is
as a
reductant that, along with
other reducing agents, minimizes damage by oxidative processes.
This role includes keeping iron and copper ions in some enzymes in their required
and
reduced form and neutralizing harmful oxidants
free radicals."
When
you add to this the new comprehension that cells can hold and use more vitamin C than previously thought, all of a
VITAMIN C AGAINST CANCER
sudden
we
lar levels
The
how
can begin to explain
C
of vitamin
megavitamin or orthomolecu-
work.
concentration of ascorbic acid in
human
This applies to
B
include monocytes,
The
"The new
report also remarks,
and
high
as
T
lymphocytes
data
come
as
estimates.
which
(T-cells).
after learning
have both low-affinity and high-affinity
transporters for ascorbic acid.
systems of different to respond
could be
peripheral mononuclear leukocytes,
lymphocytes, and
that neutrophils appear to
membrane
cells
considerably higher than previous
millimoles,
several
45
and
affinities
.
.
.
having two transport
capacities gives cells the flexibility
adjust to quite different extracellular concentrations
of the vitamin."
Now we know that erably
learn that cells have
must be
cells
C
more vitamin
of the
immune
system can hold consid-
we now
than once believed. In addition,
two mechanisms of vitamin
C
uptake. There
a reason!
In addition, vitamin
C
regenerates vitamin E,
antioxidant nutrient. Vitamin
C
which
is
prevents dietary nitrates
also
an
and ni-
from being converted into cancer-causmg nitrosamines. But, perhaps most importantly, vitamin C enhances the immune system. trites
In
my
earlier
books,
I
discussed the research of
Drs. Paul Chretien, T. F. Fehniger and
showed
that 5
grams of vitamin
of lymphocytes (white blood
cells
C
mune
who
Robert Yonomoto,
without granules) that 10
when
the
body
grams daily pro-
1971, the importance of vitamin
as
researchers
daily increased the production
was threatened by foreign substances, and 9 duced an even greater effect. As long ago
NCI
C
to the
im-
system was known. Drs. Lawrence DeChatelet, McCall and Robert Cooper reported vitamin C stimulated increased activity of white blood cells. Without copious amounts of Charles
vitamin C, white
down
cells
can engulf bacteria, but they cannot break
the bacteria.
Cancer patients have a poor ability to make new lymphocytes, and their ability to survive is in line with their ability to produce lymphocytes. After surgery, radiation treatment and most chemotherapy, the
C
immune
system
is
very weak. Even marginal vitamin
deficiency affects immunity, as demonstrated by researchers at
CANCER PREVENTION AND NUTRITIONAL THERAPIES
46 the I
UCLA
10 School of Public Health in Los Angeles. This
recommend
strongly
is
why
nutritional therapy as an adjunct to
tional cancer treatments, unless specially contraindicated
convenby the at-
tending physician.
Cancer Therapy Of course
I
am
not the only one
who
advocates using vitamin
along with other treatments for cancer.
The
study
I
C
referred to
by Dr. Pauling was begun in 1971 with the help of Dr. Ewan Cameron of Vale of Leven Hospital, Loch Lomondside, Scotland. The Cameron and Pauling study compared the results earlier
100 terminally
ill
cancer patients given 10 grams (10,000 milli-
grams) of vitamin
C
daily to the results for
for
1
,000 cancer patients
by conventional therapy without using adjunct vitamin C. Both groups of patients were treated by the same physicians in the same hospital. At the time the study report was prepared, those patients given treated
vitamin
C
had lived more than four times longer than the matched
"control" patients. pies in
When
I
wrote Cancer and
1978, 13 of the vitamin
C
patients
Its
were
Nutritional Thera-
still
alive,
with 12
of them apparently free of cancer. At that time, the survival
was more than
five times longer for the
vitamin
C
ratio
group, and
still
improving. All of the 1,000 "control" patients had died. Sixteen of the 100 vitamin
than a year,
as
opposed
C
supplemented patients lived more
to only three
of the 1,000 patients not
given vitamin C.
The
patients selected for this vitamin
nounced
C
had been pro-
trial
terminal. In the considered opinion of at least
two inde-
pendent physicians, the continuance of any conventional form of treatment would offer no further benefit.
At the time of the 1976 cancer patients had lived
matched control pain lessened.
patients.
The 1976
report,
13 vitamin C-treated colon
more than seven times
And
their quality
of
as
long
life
as
the 130
improved and
report also indicated that the vitamin
treated breast cancer patients lived six
C-
times longer than their
VITAMIN C AGAINST CANCER
47
matched control group, and vitamin C-treated kidney cancer patients lived five times longer.
Cameron and Pauling
Drs.
increased by a factor of
noted that survival time was twenty for some 10 percent of the
also
at least
This caused them to wonder what the
patients. if
treatment were started earlier and
C
were used. Dr. Pauling recommends that
we
if
we
are apparently healthy that
get at least 18 grams (18,000 milligrams) of vitamin
for optimal nourishment. Sick people
and
their disease
its
severity.
Cancer
Pauling's books Cancer and Vitamin Feel Better."*
At Dr.
results would be amounts of vitamin
if larger
this
daily
patients should consult Dr.
and
How
to
Live Longer and
2
writing Dr. Pauling
Abram Hoffer of
study
C
C
need more, depending on
came about
is
conducting
a
follow-up study with
Columbia, Canada. The
Victoria, British
serendipitously. Oncologists
were
referring can-
cer patients to Dr. Hoffer, a psychiatrist, for treatment of their
depression and anxiety. His treatment of the antioxidant nutrients. tional therapy
He
symptoms included
noticed that the patients on the nutri-
were doing
better than normally expected.
combined
Drs. Hoffer and Pauling
their efforts to study
134
cancer patients referred to them between April 1988 and April 1989. Normally, terminally to Dr. Hoffer
ill
cancer patients such
would be expected
months. However, most of those adjunct therapy were
still
as
those referred
to live an average of five to six
who were
given the nutritional
alive in late 1992. Dr. Pauling notes that
they are living an average of
1
5 times longer than
would otherwise
be expected, given their cancers.
The
fact that
vitamin
C
extends the lives of cancer patients was
confirmed by Drs. Akira Murata and Fukumi Morishige of Saga University in Japan in 1981. 5 to 30 grams of vitamin
average of 6.2 times
vitamin uterus
C
who
or
less
as
13
C
long
In their study, patients
who
received
daily as their only therapy lived as
an
those on a dosage of 4 grams of
per day. Those suffering from cancer of the
took vitamin
than those receiving
little
C
lived an average of 15.4 times longer
or no vitamin
C
In 1985, Dr. Morishige and his colleagues
supplementation.
improved
their cancer
CANCER PREVENTION AND NUTRITIONAL THERAPIES
48
treatment by adding a copper apy. This treatment has
compound with
been very
the vitamin
C
ther-
effective in animal studies
human cancer patients. 14 The Cameron and Pauling study was
and
with
orthodoxy did not believe venting or healing cancer physicians cians
who
who
published in 1976, but the
could be involved in pre-
a vitamin
that time. Unfortunately, the only
at
utilized this adjunct therapy
regularly incorporate
practices in spite
were the
nutritional
holistic physi-
advances into their
of censure and harassment by the orthodoxy. The
holistic physicians testify that
and better quality of
life
they are getting better survival rates
for their patients using the antioxidant
nutrients, especially vitamin C.
welcome
Unfortunately, the orthodox not only did not
the ad-
vancements made by Dr. Pauling's research, they attempted to destroy to
it.
show
A
study
made
C
that vitamin
at
the
Mayo
Clinic was widely purported
did not work; however, the study was
completely inadequate. 15 In the
Mayo
Clinic study, vitamin
C
was
given to patients for only 10 weeks, and not continually for the rest
of their
study.
lives, as
None of
the
was the protocol in the Cameron and Pauling
Mayo
Clinic patients died while receiving
vitamin C. Their deaths occurred only after vitamin
C
had been
discontinued.
Prevention and Therapy As
I
mentioned
earlier,
Dr. Pauling suggests that even healthy
persons should get 18 grams of vitamin
60 milligrams, but
C
this
RDA
C
daily.
The
RDA
is
only
does not consider the role of vitamin
in protecting against cancer,
heart disease and other diseases
beyond the deficiency disease, scurvy. I would suggest that you consider at least 2 to 4 grams daily for prevention, if you choose not to follow the excellent advice of Dr. Pauling for some reason. For therapy, I suggest you read Dr. Pauling's books mentioned earlier. There are less acidic forms of vitamin C available such as mineral
VITAMIN C AGAINST CANCER
49
which are easier on the digestive system than the ascorbic acid form of vitamin C. There is also a new development to consider. A new form of ascorbates,
vitamin
C
appears to be better absorbed and
is
longer, according to preliminary research. This
includes a vitamin
C
body form of vitamin C
available to the
metabolite called L-threonic acid or calcium
threonate.
In 1991 The
FASEB Journal,
the official journal of the Federation
of American Societies for Experimental Biology, reported two
more
studies shedding
light
on the
of the vitamin
role
C
metabo-
The first study showed that this vitamin C amount of vitamin C taken up by T16 cells of the immune system. The second study showed that this 17 metabolite increases the action or "potency" of vitamin C. The
lite,
L-threonic acid.
metabolite increases the
vitamin
C
metabolite, L-threonic acid,
is
available as a
food supple-
ment only in the patented vitamin C formulation having the trademark Ester- C. In June 1992, a more detailed report of the role of this metabolite
C
in potentiating the action of vitamin
was published in
Life Sciences.
in preventing scurvy
18
References 1.
Donald
Earl
Henson, Gladys Block, and Mark Levine, "Ascorbic
Acid: Biologic functions and relation to cancer," Journal of the National 2.
Cancer
Institute
(Apnl
17, 1991) 83(8):547-50.
Gladys Block, Donald Earl Henson, and
Mark
Levine, "Vitamin C:
A new 3.
look," Annals of Internal Medicine (1991) 114(10):909-10. Gladys Block, "Vitamin C and cancer prevention: The epidemiological
evidence,"
American
Journal
Clinical
of
53:270S-282S.
Nutrition
(1991)
—
5.
and you may live longer," (May 8, 1992) 325(128):1,A16. Linus Pauling and Ewan Cameron, Proceedings of the National Academy
6.
U.S. Department of Health and
4.
Susan FitzGerald, "Take your vitamins Philadelphia Inquirer
of Sciences (Oct. 1976) 73(10):3685-9.
al's report
Human
Services,
The Surgeon Gener-
on nutrition and health (Washington, D.C.: U.S.
Pnnting Office, 1988).
Government
CANCER PREVENTION AND NUTRITIONAL THERAPIES
50 7.
Committee on
Nutrition,
Diet,
and Cancer, National Research
Council, Cancer, Diet and Health: Implications for reducing chronic
risk
Academy Press, 1989) p. 593-605. Harish Padh, "Vitamin C: Newer insights into its biochemical func(Washington, D.C.: National
8.
tions," Nutrition Reviews (Mar. 1991) 49:3 65-70. 9.
Robert H. Yonomoto, Paul B. Chretien, and T. F. Fehniger, "Ascorbic acid enhances lymphocyte production." Proceedings of the American Society of Clinical Oncology (1976) 288.
10.
R.Jacob, "Immunocompetence and oxidant defense during ascorbate depletion in healthy
men," American Journal
of Clinical Nutrition (1991)
54:1302S-1309S. 11.
Ewan Cameron and
Linus Pauling, Cancer and Vitamin
C
(NY: War-
ner Books, 1981). 12.
Linus Pauling,
How
to
Live Longer and Feel Better
(NY: Freeman and
Co., 1986). 13.
Akira Murata and Fukumi Morishige, International Conference on Nutrition, Tianjin, China (June 1981) (Reported in Medical Tribune
July 22, 1981). 14.
News from
Lewis Vaughn, "Vitamins against cancer:
the front,"
Prevention (June 1985) 28-30. 15. E. T.
Creagan,
et
al.,
"Failure of high-dose vitamin
therapy to benefit patients with advanced cancer:
A
C
(ascorbic acid)
controlled
trial,"
New
England Journal of Medicine (1979) 301:687-90. 16. Michael J. Fay and Anthony J. Verlangieri, "Effects of calcium Lthreonate on ascorbic acid uptake by
FASEB Journal 17.
Anthony
J.
human T-lymphocyte
cells,"
(Mar. 11, 1991) 5(4) A588, Abstract 1266.
Verlangieri,
Anthony W. Bannon, and Michael
J.
Fay,
"Anti-scorbutic activity of L-ascorbic acid and Ester-C in the nonascorbate synthesizing
ODS
rat,"
FASEB
J.
(Mar. 11, 1991) 5(4)
A588, Abstract 1265. 18.
Anthony J. Verlangieri, Michael J. "Comparison of the anti-scorbutic
Fay, and
Anthony W. Bannon,
activity
of L-ascorbic acid and
Ester-C in the non-ascorbate synthesizing Osteogenic Disorder Shionogi (ODS) rat," Life
Sciences (June 10,
1991) 48(23) 2275-81.
CHAPTER
9
Vitamin E Against Cancer
Although
I
am
discussing the antioxidant nutrients separately, please
keep in mind that they work they provide
as a
provided by each. is
far
more
synergistically
.
That
is,
the protection
team is greater that the sum of the protection moderate balance of each antioxidant nutrient
A
effective than great quantities
of
a single antioxidant
one or more of the others. The power of synergism can be well demonstrated by
nutrient in the absence of
studies involving vitamin
E and
nium, the topic of the next chapter,
is
a trace mineral that
key component of several antioxidant enzymes.
E and
the synergistic effect of vitamin breast cancer helped explain
several
other antioxidant nutrients. Sele-
why
A
is
the
1983 report on
selenium on preventing 1
the synergism occurs. Drs. Paula
Horvath and Clement Ip of what is now Buffalo's Roswell Park Cancer Institute found that "Vitamin E, although ineffective by itself, was able to potentiate the ability of selenium to inhibit the development of
mammary
tumors."
E was a potent was not sufficient to inhibit tumor formation. Selenium alone was able to reduce tumor development, but not significantly. When adequate amounts of both vitamin E and selenium are present together, significant protection against tumor formation The
researchers noted that although vitamin
antioxidant,
it
The researchers also noted that, "Our results indicate that vitamin E facilitates the anticarcinogenic action of selenium only when it is present during the promotion or proliferation phase." results.
51
CANCER PREVENTION AND NUTRITIONAL THERAPIES
52
The researchers concluded, "An adequate intake of antioxidants would obviously be advantageous, particularly in those consuming high levels of dietary are
known
Not
all
fat,
since diets rich in polyunsaturated
to suppress certain
immune
of the epidemiological studies show
vitamin E, but most do.
The above
Looking at vitamin E by waste of time. What needs
study
1984,
a
team of
illustrates
why
or any antioxidant by
to be
done
is
now
of
don't.
all
itself,
to look at the effect
the antioxidants together. Researchers are
In
a positive effect
itself,
nutrient indices to accomplish
fats
functions."
is
of
a all
devising antioxidant
this.
British researchers led
by Dr. N.
Wald
J.
examined vitamin E and beta-carotene in the prevention of breast Blood had been collected from 5,004 women in Guernsey between 1968 and 1975, and stored frozen. By the end of 1982, cancer.
women
39 of these
developed breast cancer. Compared with
control group of other
women
of similar age, menopausal
a
status,
family history of cancer, and previous history of benign breast disease,
their blood.
Dr.
E
the breast cancer victims had lower vitamin
levels in
2
Wald concluded, "Vitamin E
significant trend in risk
having the highest
risk
had vitamin E blood
—
levels
showed
a
statistically
those with the lowest vitamin
levels
women who
of breast cancer." Overall,
levels in the
E
lowest 20 percent (quintile) of
those tested had a five times higher risk of breast cancer than those
whose vitamin E blood levels were in the highest 20 percent." The average time from collection of the blood sample until breast cancer bility that
was detected was
five years.
This excludes the possi-
an undetected tumor affected the vitamin
Beta-carotene levels tended to be lower in
oped of
a
breast cancer.
women who
As Dr. Wald noted, "There was
trend for beta-carotene, but this was not
cant."
The
E blood
researchers
level.
devel-
a suggestion
statistically signifi-
had observed relationships between low
blood vitamin E (independently) and beta-carotene (independently; and a high incidence of breast cancer. They did not look at the
two nutrients as a team. What was the risk in those women who were exceedingly low in both vitamin E and beta-carotene compared to those who were well-nourished with both? From the
VITAMIN Study of Dis. Horvath and
E alone
is
E
[p,
AGAINST CANCER it
is
53
apparent that looking
vitamin
at
missing the boat.
wasn't until the following year that Dr. Jukka Salonen and
It
University of Kuopio ^Finland^ examined the
his colleagues at the
of vitamin E and selenium together in preventing cancer. Thev had been studying over 12.000 Finns for several yean in roles
what
is called the North Karelia Project. Four years after blood was drawn from these 12,155 persons. 51 had died of cancer. Thev were matched with others by age. sex and smoking habits, and their blood samples were compared.
In this study,
many
factors
both vitamin E and selenium in
The
combination.
were examined, but most important, levels in the
blood were examined
of cancer mortality for the third people with blood selenium levels below 4~ micrograms per
ot
relative risk
of blood, compared to those with higher
liter
But of more importance selenium levels risk
who
also
is
levels,
was 5.8
to
1.
the finding that, for persons with low-
had vitamin E
levels in the lowest values,
of death from cancer compared to persons with both selenium
and vitamin E
m
levels
the upper two-thirds of values was
11.4
to 1/
Looking
at
the figures another way, those in the top third of
both vitamin E and selenium intakes had the cancer nsk that those in the tion in cancer
bottom
less
than one-eleventh
third had.
That
nsk of 91 percent with intake of
just
is
reduc-
a
those
two
antioxidant nutrients.
That proves
my
point that antioxidant nutrients can reduce your
nsk of cancer to one-tenth of the average be even more dramatic
if
we compared
risk!
The
figures
would
the cancer incidences for
people in the top tenth (decile) for both antioxidants to those the
bottom tenth
fruits
for both.
Your
objective should be to eat
and vegetables or take appropriate supplements
in the top tenth for
all
The importance of
m
enough
to put
you
of the antioxidant nutrients.
the relationship with selenium has been rec-
ognized by the National Research Center. Their 1989 booklet on "Diet and Health: Implications for reducing chronic disease risk"
concluded
"low serum
levels
of vitamin E coupled with low
sole-
CANCER PREVENTION AND NUTRITIONAL THERAPIES
54
nium may
increase the risks of at least
some
cancers such
as breast
and lung cancer." 4
Now let's
As
before leaving the role of vitamin
look I
at
said earlier,
this
is
such a large study,
it
it is
risk.
misses the
important
at.
on
In 1988, Finnish researchers reported
men from six areas drawn when the men entered of cancer
at the
a ten-year
follow-up
of Finland. Blood samples were
of 21,172 signs
in cancer prevention,
missing the boat because
is
synergistic effect, but since this
to look
E
one study of vitamin E alone in reducing cancer
the study. Subjects with possible
time the blood samples were taken and those
developing cancer within the
first
excluded from the study. Vitamin
two
E
were were measured from
years of follow-up
levels
the stored blood samples of 453 patients
who
developed cancer
during the follow-up of six-to-ten years and 841 matched controls.
Study a
results
lower cancer
showed risk.
The
that
men
with higher vitamin
E
levels
had
adjusted relative risks in the top 40 percent
(two highest quintiles) of blood vitamin
E
levels
had only 70 per-
cent of the cancer risk of the remaining 60 percent, and only 60
percent of the risk of developing smoking-related cancers.
5
It's
a
shame these researchers didn't study both vitamin E and selenium at the same time.
Other Ways Vitamin E Prevents Cancer Vitamin can
E
initiate
does not act solely by destroying the free radicals that the cancer process. Vitamin
E
also interacts directly
with some cancer-causing chemicals to inactivate them. Vitamin E, like vitamin C, prevents nitrates
and
nitrites
from being con-
verted into cancer-causing nitrosamines.
The amount of vitamin E required to optimize the immune 6 is greater than the 15 IU suggested as the RDA. Less than optimal amounts of vitamin E result in poor T-cell and B-cell responses. Vitamin E supplements have been shown to enhance
system
lymphocyte
proliferation.
7
Dr. Adrianne Bendich of
Roche Center
for
Human
Nutrition
VITAMIN E AGAINST CANCER in Nutley,
the
New
immune
55
Jersey explains the importance of vitamin
E
to
system.
"The generation of of white blood
the
cells
immune
such
These interactions include
as
response involves the interactions
lymphocytes and mononuclear
cell-to-cell
cells.
communication, and the pro-
duction of immunoreactive molecules (including interleukins, interferons,
prostaglandins
and leukotrienes). Essential
activities
also
include lymphocyte proliferation and the synthesis and secretion of
immunoglobulins
(antibodies).
taining the lymphocyte ative response."
.
.
is
important in main-
fluidity necessary for the prolifer-
8
Research The
E
Vitamin
.
membrane
Summary
Research Office of the Federation of American
Life Sciences
Societies for Experimental Biology
examined the
E and cancer for the Food and Drug 9 (FDA). The 1992 report concluded,
vitamin
"Vitamin
E
has
carcinogenesis.
been suggested
These include
a)
relationship
of
Administration
to play a role in several stages of
inhibition or blockage of
mutagen
or carcinogen formation from precursors via direct chemical interaction,
b)
prevention of mutagens or carcinogens from reaching or
reacting with
DNA by scavenging mutagens or by enhancing detoxand
ification processes,
c)
prevention of cancer progression by the
enhancement of normal immune
responses.
"In general, there are more studies suggesting tion
between higher
levels
risk
of vitamin E than those
My comment effect studied
E and other
is
a positive correla-
of cancers and lower intake or serum/plasma
that the
that
few
do not
fit
this association."
studies that missed the protective
too few persons and should have looked
antioxidants in combination.
10
at
vitamin
CANCER PREVENTION AND NUTRITIONAL THERAPIES
56
Prevention The RDA for vitamin E for adults is 15 IU. It was reduced from 30 IU purely because dieticians could not readily design diets of the proper calorie levels that contained 30 IU.
E
does not consider the role of vitamin chronic diseases.
What you
However, the
RDA
in the prevention
should be interested in
of
the Optimal
is
Daily Requirement.
You E
should consider getting
The
daily.
100 to 1,000 IU of vitamin
at least
optimal range for most people
important thing to remember about vitamin take
for a long time before
it
proper
levels. It takes at least
you
is
400 to 800 IU. The
E
you have
that
is
to
increase the cellular levels to the
60 to 90 days to achieve
this
anticancer
in
enhancing
effect.
Therapy The importance of vitamin E to cancer patients the immune system so that the body can attack prevent
it
Vitamin
E
should be administered
ability to lessen the
which include
vitamin so.
E
an adjunct therapy unless
as
One proven
benefit of vitamin
E
is
its
adverse effects of the chemotherapy drug Adriamyheart
damage and
baldness.
supplementation before the drug
The more
cells will
the cancer and
from spreading.
specifically contraindicated.
cin,
is
vitamin
E
that
can enter
cell
is
11
It is
given
best to begin
if practical to
do
membranes, the more the
be protected against the chemotherapy. Virtually
all
patients
receiving Adriamycin lose their hair; however, nearly 70 percent of the patients receiving 1600
IU of
vitamin
E
daily
days before therapy did not suffer significant hair
beginning several
loss.
12
References 1.
Paula
M. Horvath and Clement
and selenium
in the
Ip, "Synergistic effect
chemoprevention of
in rats," Cancer Research
mammary
(Nov. 1983) 43:5335-41.
of vitamin
E
carcinogenesis
VITAMIN E AGAINST CANCER 2.
N.
Wald
J.
et al,
"Plasma
57
retinol, beta-carotene
and vitamin
E
levels
in relation to the future risk of breast cancer," British Journal of Cancer
(1984) 49:321-4. 3.
Jukka T. Salonen et al., "Risk of cancer in relation to serum concentrations of selenium and vitamins A and E," British Medical Journal
4.
National Research Council, Committee on Diet, Nutrition and Can-
(Feb. 9, 1985) 290:417-20.
cer,
"Diet and health: Implications for reducing chronic disease
Academy
(Washington, D.C.: National 5.
P.
Knekt
et
"Serum vitamin E and
al.,
risk,"
Press, 1989). risk
of cancer among Finnish
men
during a ten-year follow-up," American Journal of Epidemiology (1988) 127:28-41.
6.
Adrianne Bendich, E. Gabriel, and Lawrence vitamin
E
requirement for optimum
immune
J.
Machlin, "Dietary
responses in the rat,"
Journal of Nutrition (1986) 116:675-81. 7.
Adrianne Bendich, E. Gabriel, and Lawrence dietary level of vitamin
E on
the
immune
J.
Machlin, "Effect of
system," Journal of Nutrition
(1983) 113:1920-6. 8.
E and immunity,"
Adrianne Bendich, "Vitamin
Nutrition
Report
(March 1987) 5(3)17, 21. 9.
Ching K. Chow, "Evaluation of publicly
available scientific evidence
regarding certain nutrient-disease relationships: vitamin
LSRO, FASEB, FDA
cer,"
MD: 10. Paul
E and
can-
Contract No. 223-88-2124 (Bethesda,
1991).
Knekt, "Role of vitamin
E
in the prophylaxis of cancer," Annals
of Medicine (1991) 23:3-12. 11. J. Milei et
in rabbits
al.,
"Amelioration of Adriamycin-induced cardiotoxicity
by prenylamine and vitamins
A
and E," American Heart
Journal (1986) 111:95-102. 12. L. A.
Wood,
"Possible prevention of Adriamycin-induced alopecia
by tocopherol,"
New
England Journal of Medicine (April 18, 1985).
CHAPTER
10
Selenium Against Cancer
As was noted that
is
in the preceding chapter, selenium
an essential partner of vitamin
E
a trace
is
mineral
in the prevention of cancer.
U.S. governmental agencies have recognized the role of selenium in preventing cancer in several official also
some preliminary evidence of
in the treatment
As long ago
"The
results
many malignant
Selenium was
a
C
1
and E, and the
key element in
my
known
known to
be
a
to
be an
year,
the National
rich in antioxidants
trace mineral selenium. theories, publications
patents regarding cancer prevention in 1972.
was not
and the reduction in
The following of Health recommended eating foods
including vitamins A,
that
studies suggest a correlation
to high levels of selenium
the risk of certain cancers."
is
play a vital role
tumors.
few epidemiological
a
between exposure Institutes
may
1983 the National Research Council advised
as
of
recommendations. There
that selenium
At
essential nutrient for
2
and
that time, selenium
humans, nor was
it
component of any human biochemical compound.
Selenium was of had a synergistic
interest to effect
me
in
my
with vitamin
longevity studies because
E
in helping
my
it
laboratory
animals live longer. In the 1960s,
all
that
we knew
about the biochemistry of sele-
nium was that it may have been a component of an unknown liver and kidney factor called "Factor-3" in chickens. I code-named
my
first
longevity formula for
my
laboratory animals "Factor-3X"
because of my emphasis on selenium. Surprisingly, few other scien58
SELENIUM AGAINST CANCER
59
knew about the possible biochemical roles of selenium until 1973, when it was shown to be part of the important antioxidant
tists
enzyme, glutathione peroxidase. 3 structural proteins.
Selenium
selenium has been shown several
4 5 '
now
is
Now
two other human enzymes and
to be a part of at least
considered an essential
human
nutrient with
an estimated desirable range of intake of 50 to 200 micrograms daily.
amount of selenium in food depends on soil, which varies from region to re-
Unfortunately, the
the selenium content of the
gion and
on
is
disappearing from farmed
soils (as it is
not replaced, or
which fortunately is being added to grow healthier animals. However, selenium usually decreases dramatically with the amount of processing applied to the the content of selenium in feeds,
food.
Hundreds of laboratory animal studies and dozens of epidemioand case-controlled clinical studies have now shown that
logical
the better the selenium nutrition of a person, the cancer.
The evidence
studies; epidemiological studies
and
intake, blood,
ined natural
soils;
spans,
life
less
chance for
includes prospective and retrospective clinical
based on selenium content of food
and laboratory animal
studies that
exam-
spontaneous cancers, carcinogen-induced
(dietary, contact) cancers,
virus-induced (both inoculated and not
inoculated) cancers, transplanted cancer tissue, and inoculated cancer
cells.
Many
depth of the
The
cancer researchers are aware of the breadth and
data.
clinical
confirmation that cancer probability correlates in-
versely with a person's blood selenium content (the higher the
selenium, the
less
chance of cancer) was shown epidemiologically
by Dr. Raymond Shamberger, and clinically in the 6,7 1980s by Dr. Walter Willett and his Harvard colleagues. There is no need to review hundreds of tests to make this point. I will mention six studies that make the point very well, and then describe an additional confirming study. I have reported on these
in the 1970s
studies before in the tion,
we
books Selenium Update and The
New
but the information needs to be reiterated here. learned from these six studies:
89
Supertiutri-
This
is
what
CANCER PREVENTION AND NUTRITIONAL THERAPIES
60 1.
Considering blood selenium levels alone, those persons in the lowest
fifth,
when
subjects are ranked
all
by blood selenium
content, have twice the incidence of cancer as those in the highest 2.
fifth.
7
Total cancer mortality
blood selenium
levels
is
three times higher in persons having
below
a certain value
cancer mortality in those above 3.
blood selenium
all
incidence of cancer
as
levels
total
six times the
are
needed together
11
to prevent
12
In regards to both selenium and vitamin
persons in the lowest third of also
have
those in the highest tenth.
Both selenium and vitamin E cancer.
5.
than the
10
Considering blood selenium levels alone, those persons in the lowest tenth of
4.
this value.
had
a
all
low blood selenium
E blood levels, those E levels who
blood vitamin
had more than 11 times
level
the incidence of cancer as those in the upper two-thirds of
blood vitamin E and selenium 6.
Another study was published
levels.
in
13
which the researcher con-
cluded that "selenium should be considered not only
as
a
preventive, but also as a therapeutic agent in cancer treatment
and may
act additively or synergistically
ray treatments."
Selenium
many
is
is
glutathione peroxidase;
it
repair
itself;
it
a it
component of stimulates the
(as
the antioxidant enzyme,
immune
system;
it
reduces the action of carcinogens on
suppresses gene mutations; and
actions
X-
involved in protecting the body against cancer in
ways. Selenium
DNA
with drug and
14
it
regulates certain
enzyme
helps
DNA; inter-
discussed in the previous chapter).
Study Details You may
find the details of the six studies of interest. If not, just
skip ahead to the concluding section of this chapter.
summaries of the measure.
six studies plus
Here
one confirming study
are brief for
good
selenium against cancer
61
The Willett Study This study for
is
of major importance, not only for
influence.
its
The
its
research, but
Willett study was conducted by a well-re-
spected group of researchers, and the
work was done
at
major
centers of learning: Harvard, Johns Hopkins,
of Texas, and other respected
Duke, the University The results were pub-
universities.
lished in a
major medical journal, rather than an obscure
periodical.
Many
nium
levels
and
scientific
physicians read of the importance of blood seletheir relationship to cancer risk for the
first
time,
thanks to this study. In the Willett study, blood samples had been collected in 1973
from 4,480
men from
14 regions of the United
of collection of the blood samples, none of the signs
States.
At the time
men had
detectable
of cancer. The blood samples were preserved and stored for
later analyses.
During the next in this group. ples
The
five years,
111 cases of cancer were detected
researchers then retrieved the stored blood sam-
from these men, and from 210 other
men who were
selected
because they matched the newly developed cancer patients in age, race, sex,
and smoking
history.
The
levels
of several nutrients and
other factors were compared between the
cancer and those
One
men who
remained
free
men who
developed
of cancer.
difference stood out as being highly significant.
of cancer for subjects in the lowest in the highest fifth.
fifth
was
twice that
The
risk
of subjects
7
Dr. Willett's group reviewed the evidence of the association of
low blood selenium levels and cancer at a symposium whereby the results were published the following year. 15
in
1990,
The Chinese Study This study, examining the relationship between blood levels of
selenium in 1,458 healthy adults in 24 regions of China, was led
by Dr. Shu-Yu
Yu
of the Cancer
of Medical Sciences
was
a
statistically
in Beijing.
Institute
The
of the Chinese Academy
researchers found that there
significant inverse correlation
between age-
CANCER PREVENTION AND NUTRITIONAL THERAPIES
62
adjusted cancer death rates and the selenium levels of the blood
of
local residents. In the areas
with high selenium
levels, there
was
significantly lower cancer mortality in both males and females.
Total cancer mortality was three times higher in areas where the
mean blood selenium deciliter
Dr.
level
was greater than 11 micrograms per
of blood then where
it
Shu-Yu Yu confirmed
reported three years lager.
was 8 micrograms per
deciliter.
these results in studies that
10
were
1617
The Clark Study Dr. Larry Clark and colleagues
at
Cornell University determined
the blood selenium levels in 240 skin cancer patients and
compared
the results to those from 103 apparently healthy persons living in
low-selenium
The mean blood selenium
areas.
level for the skin
cancer patients was significantly lower than that of the apparently
damage
to the skin,
and other
factors, the
healthy individuals. After adjusting for age, sun
blood beta-carotene and vitamin
A
levels,
incidence of skin cancer in those persons in the lowest tenth of blood
selenium It
was 5.8 times
levels
as great as
those in the top tenth.
should be noted that selenium, in the form of the
11
common
food supplement L-selenomethionine, can protect skin against sun-
induced damage. 18 Interestingly, the selenium compound protects
whether taken
orally or applied to the skin.
The Horvath Study The preceding
studies
have dealt with
real people,
but
let's
an important laboratory animal study for a moment. Most experiments examine one variable just that
one
variable.
at a
look
at
scientific
time to study the effect of
This reduces confusion from confounding
Yet, the body is not a simple laboratory! It is a biologically complex mechanism that functions independently of science's effort
factors.
to study I
it.
have stressed the biological synergism of
nutrients, but
I
do so
preceding chapter,
I
especially
of vitamin
all
E and
the antioxidant
selenium. In the
discussed the study published
by Drs. Paula
SELENIUM AGAINST CANCER
Horvath and Clement
Ip that
selenium must be present
showed
together to
critical,
which
enzyme
E and
both vitamin
that
prevent the proliferative phase
of cancer. Their evidence indicates that the selenium-containing
63
it
not the amount of
is
(glutathione peroxidase) that
is
but the amount of another enzyme, microsomal peroxidase, is
stimulated only
present together.
The message here correlation
when both
E and selenium
vitamin
are
12
that scientists should not
is
between blood selenium
levels alone
be studying the
and cancer, but
they should be studying the correlation between blood levels of
selenium and vitamin
E
in fact, find that there
is
E and some
We
find the same relationship
types of cancer, as
preceding chapter. However,
when
a person's
we
blood
noted in the is
E
that
both
rich in
selenium and vitamin E, the protection given that person
more than
do,
with
a substantial reduction in cancer risk
the higher blood selenium levels.
with vitamin
we
together. Studying selenium alone,
is
far
of adding the selenium protection and the vitamin
protection together. If a
person has a normal blood level of vitamin E, but
deficient in selenium, that person will not have a against cancer. Conversely, if a person
is
a
little
low
but well-fortified with selenium, then that person
is
very
good defense in vitamin E,
may be more
resistant to cancer.
Since the vitamin
E
level
of the blood can
of selenium, researchers should be looking els
—not
just simply
to this concept,
we
at
affect the usefulness
the
combined
lev-
other. Once researchers catch on more dramatic results. This becomes
one or the will see
apparent in the next study.
The Finnish Study Dr. Jukka Salonen and his colleagues
at
the University of
Kuopio
been studying over 12,000 Finns for several years. as the North Karlia Project. Four years after blood samples were drawn from these 12,155 persons, 51 had died of cancer. They were matched for age, sex and smoking habits with others, and the results of their blood samples were compared. in Finland have
The
study
is
known
CANCER PREVENTION AND NUTRITIONAL THERAPIES
64
In this study,
many
were examined, but most important, levels of the blood were examined
factors
both vitamin E and selenium in combination.
The
of cancer mortality for the third
relative risk
below 47 micrograms per levels was 5.8 to 1. the finding that for people with low
of people with blood selenium
levels
of blood compared to those with higher
liter
But of greater importance is selenium levels who also had vitamin E the
risk
of death from cancer compared
and vitamin
both selenium to
E
in the
to
levels in the lowest range,
persons having blood levels of
upper two-thirds of values was 11.4
1.
The Milner Review Dr. John A. Milner of the University of
Illinois has
been studying
selenium and cancer protection for about two decades. Most of Dr. Milner's studies involve transplanting or inoculating cancer cells
mice receiving
into
or drinking water.
opment of such
He
different levels
cancers.
Dr. Milner's conclusion
not only
as a
treatment.
15
of selenium in their food
has found that selenium inhibits the devel-
is
that
selenium should be considered
preventive, but also as a therapeutic agent in cancer
There
is
also
some evidence
additively or synergistically with drug
that selenium
may
act
and/or radiation treatments.
In addition to Dr. Milner's review, Drs.
Gerald
Combs and
Larry Clark of Cornell presented an excellent review of selenium's protective roles against cancer in the trition
Reviews.
to pursue.
on the
At
role
They provided 97 this
November 1985
issue
of Nu-
references for the serious scholar
writing there are
now
over 400 related
articles
of selenium in cancer prevention.
Cancer Therapy In the early 1970s,
nium was
when
it
was
clear that optimal intake
of
sele-
protective against cancer in laboratory animals, Dr. Ger-
hard Schrauzer of the University of California
at
San Diego and
called for clinical trials to test for this capability in
I
humans. Dr.
SELENIUM AGAINST CANCER Schrauzer had completed
a series
65
of experiments that showed that
optimal selenium intake could reduce the natural occurrence of
mice by nearly 90 percent,
breast cancer in
the usual cancer rate.
19
He
to only 12 percent
Cancer
told the National
1978 that the key to cancer prevention
lies
of
Institute in
in assuring adequate
selenium intake. Dr. Schrauzer stated in a 1978
woman
that if every
in
America
article in
ments) today, or had a high-selenium
would
breast cancer rate if a breast
Family
magazine
Circle
started taking selenium (supplediet,
within a few years the
decline drastically.
He
also
remarked
tendency to develop metastases (other tumors spread from the is
that
cancer patient has low selenium levels in her blood, her
increased, her possibility for survival
nosis in general
is
poorer than
if
is
first)
diminished, and her prog-
she had normal blood selenium
levels.
In 1983,
reported in the
I
first
update of this book the encourag-
ing results of Dr. Richard Donaldson of the
Louis Veterans
St.
Administration Hospital. Dr. Donaldson passed away before he
could complete
his studies or publish his preliminary results,
but
information should be reported again.
this
Dr. Donaldson did orally present his data to the National Cancer Institute,
involving the
140 patients enrolled in
first
cording to Dr. Donaldson's the study
were
letters,
Some of the
the patients
being terminally
certified as
after receiving the appropriate
ticular cancer.
all
ill
his study.
who
Ac-
entered
by two physicians
conventional therapy for their par-
patients
who
entered the program with
only weeks to live were alive and well after four years, and with
no all
signs or
symptoms of
cancer.
had reduction in tumor
size
Not
and
all
pain.
patients It is
were cured, but
unfortunate that they
did not receive the selenium until they were pronounced incurable.
This research It
is
may
well change cancer therapy in the future.
important to realize that the dramatic improvements did
not occur until sufficient selenium was ingested to bring the patient's
blood selenium
be achieved in
nium per
a
level
up
to normal.
few weeks with 200
to
Sometimes
this
could
600 micrograms of
day, while other individuals required as
much
as
sele-
2,000
CANCER PREVENTION AND NUTRITIONAL THERAPIES
66
micrograms of selenium per day to normalize the blood selenium levels.
The
critical factor
is
to have a physician
monitor blood selenium
Since not every laboratory can analyze blood for selenium
levels.
may have
content, the physician
blood samples to
to send the
regional laboratories. Physicians wishing
more information
to
as
may wish
the preferred blood selenium level for cancer patients
to
write directly to Dr. Schrauzer. In Dr. Donaldson's clinical trials, no signs of selenium toxicity were observed in any patient even in the autopsies of the 37 patients who were helped, but not cured by the therapy. It should
—
be pointed out that other antioxidant nutrients, including vitamins A,
C
and E, were
used in Dr. Donaldson's program.
also
Selenium Supplementation The important
aspect of selenium nutrition
of selenium in the blood and be
a threshold level that
for the
body
to
is
that
it is
the
amount
There appears to the blood in order
tissues that counts.
must be maintained
in
produce adequate amounts of the antioxidant en-
zymes, the selenium-containing peroxidases. Since selenium-containing foods can vary in selenium content by
over
a thousandfold,
depending on where the plants were grown or
what the animals were
book
fed,
it is
apparent that one should not trust
values for estimating the selenium content of the diet. In
opinion, the only practical
way
to ensure that
you
my
get adequate
amounts of selenium is to take selenium supplements. Supplements are measured amounts of nutrients. The "official" recommended range for selenium is 50 to 200 micrograms per day. I feel that this is too low, and that 400 to 500 micrograms daily would more closely approximate the intake of the low-cancer populations of Japan, who consume about 600 micrograms daily. This also approximates the extrapolation of Dr. Schrauzer, which indicates that this level would lower the cancer incidence to just above the no-incidence level.
Assuming
that
you do
get
some selenium
in
your
diet,
you may
SELENIUM AGAINST CANCER
wish to consider taking 200 (or even daily as a supplement.
grams daily
as a
Cancer
patients
67
as much as 400) micrograms may wish to take 600 micro-
supplement.
However, selenium, like almost all substances, is toxic in excess. important to remember that the toxic level for selenium begins
It is
above the safe range of 1,000 micrograms per day. This may lower for some persons and for some forms of selenium. Unless be your blood level of selenium is monitored by a physician, do not
just
exceed the above-mentioned
levels.
References 1.
Diet, Nutrition,
and Cancer: Directions for
research,
Committee on
Diet,
Academy
Press,
Nutrition, and Cancer, (Washington, D.C.: National 1983). 2.
Nutrition
Diet,
&
Cancer Prevention,
National Institutes of Health,
& Human
Public Health Service, U.S. Department of Health
3.
NIH
Ser-
No. 85-2711 (Nov. 1984). J. T. Rotruck, A. L. Pope et al., "Selenium: Biochemical role as a component of glutathione peroxidase," Science (1973) 179(73):588vices,
Publ.
90. 4.
F. Ursini,
M. Maiorino and
C. Gregolin, "The selenoenzyme phos-
pholipid hydroperoxide glutathione peroxidase," Biochem.
Biophys.
Acta (1985) 839(l):62-70. 5.
M.
J.
Berry, L.
deiodinase
is
a
Bann and
P.
R. Larsen, "Type
I
iodothyronine
selenocysteine-containing enzyme," Nature (1991)
349(6308) :438-40. 6.
Raymond J. Shamberger and C. E. Willis, "Selenium distribution and human cancer mortality," CRC Crit. Rev. Clin. Lab. Sci. (1971) 2(2):211-21.
7.
W.
C. Willett
et
al.,
"Prediagnostic serum selenium and risk of
cancer," Lancet (July 16, 1983) 11:130-4. 8.
Richard A. Passwater, Selenium Update, (New Canaan, Conn: Keats Publishing, Inc., 1987).
9.
Richard A. Passwater, The
New
Supemutrition,
(New York: Pocket
Books, 1991). 10.
Shu-Yu Yu and
its
et
al.,
"Regional variation of cancer mortality incidence
relation to selenium levels in
Research (Jan.-Feb. 1985) 7:21-9.
China,"
Biological Trace
Element
CANCER PREVENTION AND NUTRITIONAL THERAPIES
68 11.
Lawrence C. Clark case-controlled
et
al.,
study,"
"Plasma selenium and skin neoplasms: Nutrition
&
Cancer
(Jan
-March
A
1984)
6:13-21. 12. Paula
M. Horvath and Clement
Ip,
"Synergistic effect of vitamin
E
and selenium in the chemoprevention of mammary carcinogenesis in rats," Cancer Research (Nov. 1983) 43:5335-41. 13.
Jukka T. Salonen, "Risk of cancer in relation to serum concentrations of selenium and vitamins A and E," British Medical Journal (Feb. 9, 1985) 290:417-20.
14.
John A. Milner, "Selenium and the transplantable tumor," Jo urnal of Agricultural and Food Chemistry (May-June 1984) 32:436-42. Walter C. Willett et al., "The epidemiology of selenium and human
15.
cancer," In: Antero Aitio, editor, Proceedings of the Joint Nordic Trace
Element Society/Union of Pure and Applied Chemistry International
16.
Symposium 1990. (1991) 141-55. Shu-Yu Yu, Y. J. Chu, and W. G. of
liver
Li,
cancer in animals and possible
"Selenium chemoprevention
human
applications," Biolog.
Trace Element Res. (1988) 15:231-41. 17.
Shu-Yu Yu activity
18.
et
al.,
"Biochemical and
of selenium,"
Biolog.
cellular aspects
of the anticancer
Trace Element Res. (1988) 15:243-55.
Karen E. Burke, "Skin cancer protection with L-selenomethionine," Nutrition Report (Oct. 1992) 10(10):73,80.
19.
Gerhard Schrauzer and D. Ishmael, Annals of Science (1974)
4:441-7.
Clinical
and Laboratory
CHAPTER
11
Sulfur-Containing
Antioxidants
The
antioxidant nutrients discussed in the previous chapters are
the most critical because they are the ones in shortest supply in the diet. to help
However, the bulk of antioxidant
nutrients are
keep these scarcer nutrients in their active
uses sulfur
compounds
state.
needed
The body
called thiols to achieve this recharging
and
compounds
also
recycling of the trace antioxidants. These sulfur are potent antioxidants themselves.
My
original research used the sulfur-containing
thionine and cysteine, and
Now we
are aware
amino
acids
me-
the tripeptide glutathione extensively.
of additional powerful sulfur-containing nutri-
ents to help us.
Sulfur nutrients tend to have distinctive odors. Foods such as garlic,
may
onions, cabbage, and eggs are rich in sulfur nutrients.
also
wish to include sulfur-containing nutrients
in
You
your sup-
plementation program.
Lipoic Acid Lipoic acid (also called thiotic acid)
may become an important
is
a
powerful antioxidant that
nutrient by the late
69
1990s.
It
is
not
CANCER PREVENTION AND NUTRITIONAL THERAPIES
70
now
considered essential for humans,
bodies
—but can we make enough
as
we
make some
can
optimum
for
m
our
health?
Several researchers are studying the advantages of supplementation with lipoic acid, interest in the next
and
few
should become of increasing
this nutrient
vears.
Glutathione is the body's major antioxidant and is normally proample quantities provided one eats ample sulfur-
Glutathione
duced
in
m
containing foods, especially those rich tathione
is
antioxidant
— except
in
function because their nally,
AIDS
cells to work as an AIDs patients lose immune make enough glutathione inter-
patients.
cells can't
and glutathione made outside of the deficient
sorbed from food (the
cysteine or cystine. Glu-
well-absorbed and readily enters
AIDS
is
not transported across
cells
or ab-
infected with
HIV
virus).
However, another sulfur-containing cysteine) can penetrate
amounts
cells
HIV-infected
of glutathione
so
as
nutrient,
cells
restore
to
NAC
(N-acetyl-
and produce
significant
immune
significant
function.
N-acetylcysteine N-acetylcysteine foods, but the
(NAC)
most
is
found
reliable source
of interest to researchers for
its
in is
(NAC) quantities
small
NAC
in
supplements.
several
NAC
is
antioxidant effects in preventing
cancer and reducing harmful lipoprotein (alpha) levels which are a factor in heart disease.
It is
also
of interest in
AIDS
research.
Cysteine, Cystine and Methionine These sulfur-containing amino foods,
and are
also available as
acids are present in
food supplements.
most
sulfur-rich
SULFUR-CONTAINING ANTIOXIDANTS
71
Garlic Garlic
is
a rich
source of sulfur compounds, including the powerful
antioxidants ajone and dithiins, and other thiols. lic-eating peoples
The
world's gar-
have lower cancer incidences than those
not make the herb a regular part of their
who do
diet.
Sulfur-containing nutrients used to be in favor with the old-
time nutritionists, but yet to catch feel that
you
it
will take
modern
up with the science of will
be reading quite
nutrients in the years to
come
as
nutritionists
some time
these protective nutrients.
a lot
I
about sulfur-containing
they are rediscovered.
CHAPTER
12
Trace Minerals, Antioxidant Enzymes
and Pro-Oxidants
Earlier chapters
min
A
have covered the major antioxidant nutrients,
and beta-carotene, vitamin C, vitamin E, the
vita-
trace mineral
selenium and sulfur-containing nutrients. These are the nutrients
you can body makes itself,
However, your complex antioxidant enzymes to protect needed for the body to manufacture these
take to reduce free-radical damage.
that
additional
and nutrients are
enzymes. I
have already described
dant, but that dases, using
how
selenium
as a
(lipids)
radicals are
nium
is
Other
itself
is
not an antioxi-
key component. The peroxidases destroy
free radicals called peroxides. fats
selenium
your body makes antioxidant enzymes, the peroxi-
in
our
formed
cell
When
other free radicals attack the
membranes, new and very harmful
free
called lipid peroxides. Therefore, dietary sele-
essential for
your antioxidant defense.
trace minerals are also important for the antioxidant en-
body forms from them. The trace minerals zinc, copper and manganese are part of the antioxidant enzyme called
zymes
that the
superoxide dismutase (SOD). cal,
superoxide, into the
less
SOD
converts the oxygen-free radi-
harmful peroxide, hydrogen peroxide. 72
TRACE MINERALS, ANTIOXIDANT ENZYMES AND PRO-OXIDANTS Therefore, will not
if
we
are deficient in zinc,
SOD
produce adequate
and
copper or manganese, free
radical
73
we
damage from
superoxide radicals can occur. Iron
is
catalase. Catalase
SOD
need
many
essential for
in cancer prevention
radicals. If
and
we
is
reasons, but of special interest to us
that iron
is
part
of the antioxidant enzyme
converts hydrogen peroxide into water. Thus,
we
catalase for optimal protection against superoxide
are iron deficient,
we
aren't as well protected as
we
could be.
Pro-oxidants It is
not that simple, however! Iron and copper are also pro-oxi-
dants.
That
free ions
is,
iron and copper,
when
in the
blood and
and not protected by proteins or serving
needed to protect
of com-
as parts
pounds, react with body components to form free are
tissues as
They
radicals.
against free radicals, but in excess, they can
also cause free radicals.
During the next few
years,
my
research will concentrate
on
finding the optimal amounts of each for optimal health, including
prevention of cancer and heart disease. Until more research
is
avail-
recommendation appears to be to strive for the RDA and not under-supply or over-supply your with any trace mineral. There is also another complication.
able, the best
for each trace mineral diet
Competition and Balance Trace mineral balance
is
essential.
Many
much of one other. This
is
trace mineral
you may
compete you take too
trace minerals
with one another for absorption and transport.
If
lessen the absorption
especially true for zinc
and copper. Calcium
blocks the absorption of zinc, copper and selenium, yet
adequate amounts of calcium This
may
also explain
why
ing that copper deficiency
as
I
will discuss in
Chapter
also
we need 14.
the epidemiological studies are
is
of an-
show-
associated with higher cancer risk,
CANCER PREVENTION AND NUTRITIONAL THERAPIES
74
and an
of copper
excess
The same
is
also 'associated
true so far for zinc; zinc deficiency
is
higher cancer risk and zinc excess cancer
Or
risk.
with a higher cancer
the variance
is
associated with
is
also associated
may be merely due
risk.
with higher
to study variations
in the methods.
Immune Response These
because they affect the per
are
all
immune
key nutrients for
deficiency impairs the
much
is
also
response. Selenium, zinc and cop-
a healthy
immune
excess of zinc also impairs the
because too
which
enzymes your cancer defense
trace minerals are important for the antioxidant
that they form, but they are also important in
immune
response, but
immune
response.
it
A
zinc
appears that an
response.
Would
that
be
zinc interferes with the absorption of copper,
needed
for a healthy
immune
system?
Recommended Amounts In review, the trace minerals zinc, copper, manganese and iron are critical for
cancer prevention. However, too
may be
detrimental
Here
as
are the
as
too
little.
much
out of balance
Follow the RDAs.
1989 RDAs:
zinc (men)
(women) copper
manganese iron (men)
(women)
mg (elemental) 12 mg (elemental) 1.5-3 mg (elemental) 2—5 mg (elemental) 10 mg (elemental) 15 mg (elemental) 15
CHAPTER
Vitamin
13
B Complex
Against Cancer
So
far,
we
have discussed the major antioxidant nutrients and
they prevent cancer by destroying cancer-causing free
though some of the B-complex vitamins their functions are to
form the coenzymes
are
minor
how
radicals.
Al-
antioxidants,
that in turn
form many
of the thousands of enzymes that make your body chemistry work.
However, there
is
more
your
DNA
that repairs
and immune system. Your and reproduces your
are linked together to If
your
to cancer protection than destroying
You must
the free-radical aggressors.
DNA
is
vital
it
maintain the health of
DNA
is
the protein factory
components.
form the genetic
damaged,
also
DNA molecules
material, the
may produce
chromosomes.
mutations of your
cells
you allow poor nutrition to weaken your DNA, then the DNA becomes faulty even if there is no freeradical aggressor at all. Free radicals can harm healthy DNA, but poor nutrition can bring about the same result and lead to cancer. Cancer protection requires that first of all, you are well-nourinstead of exact copies.
If
you must protect yourself from the inevitable free your body no matter how "careful" you and thirdly, you should avoid overexposure to free-
ished. Secondly,
radicals that always are in try
to be,
radical sources.
The B-complex
vitamin, folic acid (also called folate, folacin or
75
CANCER PREVENTION AND NUTRITIONAL THERAPIES
76
pteroylglutamic acid), is
the
weak
link
Reviews puts
tion
is
DNA.
required for healthy
—and even missing
link
—
in
"Folic acid deficiency
it,
In
fact, it
often
DNA health. As Nutriassociated with a
is
chromosomal abnormalities. Chromosome breaks, gaps, despiralization and increased sister chromatid exchanges have been
variety of
reported in the setting of folate deficiency." In other words, a variety of types of
when there
there
folic acid nutriture.
been often cited
when
there
adequate
Thus,
is
a folic acid deficiency,
is
is
many
when
risk
of birth
'
is
defects.
2
The bad news folic acid. is
our
In
num-
3
Dr. Charles E. Butterworth,
Jr.
and
his colleagues at the
of Alabama Medical School have linked
sity
there
folic acid deficiency at
nutritionists feel that folic acid deficiency 1
that has
chromosomal damage
but doesn't
not surprising to learn that
ber-one vitamin deficiency.
to
example
most Americans do not get adequate amounts of
fact,
when
not occur
1
conception leads to a greater is,
damage can occur
A common
that caffeine produces
folic acid nutriture. it
DNA
a folic acid deficiency that will
is
adequate
is
1
Univer-
folic acid deficiency
both cervical cancer and lung cancer. They reported in the
women
Journal of the American Medical Association that
ciency of folic acid were five times
develop the precancerous
when exposed
to the
cell
human
cussed later in Chapter 23
note that
when women
more
with
a defi-
likely than others to
growth known
as cervical dysplasia
papilloma virus. 4 This will be dis-
on Cervical Cancer.
It is
interesting to
taking oral contraceptives have Pap smear
showing the presence of precancerous dysplastic cells, merely improving the folic acid nutriture quickly normalizes the results of 5 the Pap smear test. Dr. Butterworth's group also reported that vitamin B12 and folic tests
acid together appear to reverse or decrease precancerous changes in the lungs
of cigarette smokers. Smokers treated for four months
with high doses of these two B-complex vitamins showed cant
improvement
from a
study.
6,7
a
number of precancerous
cells in
signifi-
sputum
men who smoked
at least
day for 20 years or more, and was confirmed by
a later
their lungs.
pack
in the
The
study involved 88
VITAMIN B COMPLEX AGAINST CANCER
77
Dr. Butterworth said that the treatment was "a poor substitute for stopping
smoking," but added that
"this
may
enable doctors
growths from developing into lung cancer. very encouraging evidence, first to support the
to prevent premalignant
We
think this
is
concept of localized vitamin deficiency, and second, explain
some of
the underlying mechanisms by
may
it
which
cells
help are
altered genetically."
DMG
Choline and
A
deficiency of choline
may
also initiate cancer.
vitamin for humans because
Choline
we
is
not
make some choline from the amino acid methionine. However, many researchers feel that we may not always be able to make as much choline as we should for optimum health, and they group choline "unofficially" in with the B-complex family of vitamins. considered an
What we
official
are really
concerned with
is
the availability of a portion
of the molecule normally supplied by the called a
can
essential
amino
acid
"methyl group." The body does not synthesize methyl
groups and depends on the diet for these groups of atoms. These pre-arranged atoms are needed to
make many compounds
includ-
ing choline.
We
depend primarily on our total intake of methionine, choline, (DMG) and betaine (trimethylglycine) for the la(easily used) methyl groups needed for transmethylation (do-
dimethylglycine bile
nated methyl groups for our body's needs).
ReFood and Drug Administration reported at
Dr. Lionel Poirier of the National Center for Toxicological search Division of the
an American Institute for Cancer Research Conference that "a scarcity
of methyl groups can change the structure of the
DNA
molecule, leading to breaks and rearrangements that can profoundly affect the genetic
be cancer."
machinery of the
cell.
One
of the
results
may
8
A deficiency of choline plus the other methyl group donors can induce cancer even in the absence of carcinogens and/or free radicals.
Researchers
at
the University of
Toronto fed
rats a diet
low
CANCER PREVENTION AND NUTRITIONAL THERAPIES
78
in choline livers
and methionine and found precancerous changes
precancerous changes.
Dimethylglycine tor
in their
within ten weeks. Choline supplementation prevented these 9
(DMG)
has
of both branches of the
been found
immune
to
system.
be
a
potent stimula-
1011
References 1.
"Folate
parenteral
deficiency,
and cytogenic damage in
caffeine,
mice," Nutrition Reviews (Sept. 1991) 49(9):285-7. 2.
M. Laurence
K.
et
"Double-blind randomized controlled
al.,
folate treatment before
tube defects," 3.
I.
British
trial
of
conception to prevent recurrence of neural-
Medical Journal (1981) 282:1509-11.
Eto and A. Sancar, "Role of vitamin B-12 and
folate deficiencies
in carcinogenesis," In: Essential nutrients in carcinogenesis. L. A. Poirer,
M. W.
Pariza,
and
P.
M. Newberne,
eds.
(NY: Plenum
Press, 1986),
313-30. 4.
5.
C. E. Butterworth,
Jr.;
K. D. Hatch
cervical dysplasia,"
JAMA
C. E. Butterworth
et
al.,
et
al.,
"Folate deficiency and
(1992) 267 (4): 528-33.
"Improvement of
cervical dysplasia associ-
ated with folic acid therapy in users of oral contraceptives," American Journal of Clinical Nutrition (1982) 35:73-82. 6.
"B
7.
D. C. Heimburger
vitamins help reduce squamous metaplasia in smokers," The Rec-
ord (1986) 12/4. et
al.,
"Improvement
in bronchial
squamous
metaplasia in smokers treated with folate and vitamin B-12," Journal of the American Medical Association (1988) 259:1525-30. 8.
Lionel Poirier, "Research Update: Probing the effects of methyl deficiency," American Institute of Cancer Research Newsletter
(Summer
1991) #32. 9.
A. Ghoshal, T. Rushmore, and E. Farber, "Initiation of carcinogenesis
by
a dietary deficiency
of choline in the absence of added carcino-
gens," Cancer Letters (1987) 36:289-96.
Reap and J. W. Lawson, "Stimulation of the immune response by dimethylglycine, a nontoxic metabolite," J. Lab. Clin. Med. (1990)
10. E. A.
115(4):481-6. 11.
C. D. Graber,
J.
M.
Goust,
et
al.,
of dimethylglycine in humans,"J.
"Immunomodulating
Infect.
properties
Disease (1981) 143(l):101-5.
CHAPTER
14
D and
Vitamin
Calcium Protect Against Some Cancers
Few
—
suspected a link
—between vitamin D and
direct or indirect
cancer prevention, but lo and behold there F.
is.
In 1988, Drs. Cedric
Garland and Frank C. Garland of the University of California
School of Medicine
San Diego published
at
book
Calcium Connection. This tionship
between vitamin
D
deals
a
book
entitled
with their studies of the
The rela-
and calcium and preventing breast and
colon cancers. In 1979, they sity that
were attending
a lecture at
Johns Hopkins Univer-
included maps showing the incidence of each of the major
maps the Na-
cancers for each of the 3,056 counties in the U.S. These
colleagues at J. Mason and his from data supplied by the National Center published some of these maps in the first
were prepared by Dr. T. tional
Cancer
Institute
for Health Statistics.
I
edition of Cancer and
Its
Nutritional Therapies,
and they are repeated
here for your convenience.
Note, by looking it
is
at
the
and
fifth
obvious that people living
in
last
map, "Melanoma,"
warmer
climates have
that
more
exposure to the sun and thus more overexposure to ultraviolet energy; thus, people living in
wanner 79
climates have
more
skin
CANCER PREVENTION AND NUTRITIONAL THERAPIES
80 cancer.
Now
males."
Do you
look
at
the third figure, "Breast cancer, white fe-
see a pattern?
Dr. Cedrick Garland did. He noticed that it looked as if someone had drawn a heavy line along the 40th parallel through the middle of California, and the tops of Arizona, New Mexico, Texas, Tennessee and the Carolinas. The vast majority of the high breast
—
cancer areas are North of cancer areas are South of
while most of the low breast
this line
it.
The same
true of the
is
map
for colon
(large intestine) cancer.
For both cancers, there
is
showing
a correlation
North
gradient of mortality rates from
to
South.
a
decreasing
"At
we
first
thought that the link was due to differences in the diet between
North and South, but when we look at data from the Department of Agriculture, we found that (no dietary pattern) fitted the the
map we had produced for cancer." The next obvious explanation would be exposure to sunlight. The warmer the climate, the more skin exposure to sunlight. The 1
more
D
more vitamin
sunlight reaching the skin, the
that the
body
forms in the skin from cholesterol-derived compounds. So the decided to look
scientists
Where tern
—
there
at
the possible role of vitamin D.
were some apparent exceptions
to the
map
pat-
in the South, these can also be explained by
in large cities
the sunlight theory. People living in large cities live in polluted air that blocks sunlight
country
The
and
live in the
shadows of
tend not to wear short-sleeve
city folk
folk,
shirts
tall
buildings. Also,
and shorts
In 1984, the Drs. Garland convinced
tioned in Chapter
7,
on lung
to look into calcium searchers,
originally
who
The
some of the
looked into the
effects
cancer, to use their data
and/or vitamin
by Drs.
led
Stamler, conducted the living near
often as
and they tend not to be outside in the sunniest hours. 2
Drs. Garland published their hypothesis in 1980.
beta-carotene
as
Western
D
researchers
of vitamin
found
D
and
and colon cancer. The
re-
Richard Shekelle and Jeremiah
Electric
that the risk
Study wherein 1,954
men
years.
of colon cancer was inversely
D and calcium. When the comand calcium were ranked, and then
correlated with dietary vitamin
bined intakes of vitamin
A
bank and blood samples
Chicago volunteered to be studied over 20
researchers
men-
VITAMIN D AND CALCUM PROTECT AGAINST SOME CANCERS
grouped
as
81
"fourths" or "quartiles" from lowest to highest intakes,
the observed risks were 38.9, 24.5, 22.5 and 14.3 per 1,000 popula-
This association remained significant after adjustment for age,
tion.
cigarette
smoking, body mass index, alcohol consumption, and per-
centage of calories obtained from
The
fat.
3
D
study found that a dietary intake of vitamin
3.75 micrograms of vitamin
D
greater than
per day was associated with
a
50
percent reduction in the incidence of colorectal cancer, and that a dietary intake of
1200 milligrams or more per day of calcium was
associated with a 75 percent reduction.
The
Drs. Garland and their colleagues continued to look into this
possible relationship. Later they reported that "people
400 IUs of vitamin
who
those rates
get less."
D 4
who
get at least
daily are half as likely to get colon cancer as
Dr. Garland also suggested that "breast cancer
could be significandy cut by
a diet rich in
vitamin D."
4
In 1989, Dr. Garland explained, "It appears that cancer
vented because you need vitamin
from
inhibits cells
proliferating
D
incidence of breast and colon cancer."
D
indicate
that
D
Cells that are tightly
bound together grow
Individual
cells
vitamin
D
cells to
grow
An
is
.
We're
when
studies
of the
an adequate
present, the cells bind together tightly. in a very regulated
are then less able to run out
of control.
way.
When
lacking, the binding loosens, leaving the cancer-prone
uncontrolled.
The
result
often cancer."
is
1
eight-year study of 25,802 Maryland residents found that
people with blood levels of vitamin
more
.
1
amount of vitamin
is
.
will reduce the overall
"Recent European
In 1990, Dr. Garland added,
metabolic roles of vitamin
D
pre-
and calcium
to absorb calcium,
and becoming cancerous.
confident that increasing dietary vitamin
is
daily
of vitamin
D
had
D
that correlate to
400 IU or
half the risk of colon cancer of those
with lower amounts of vitamin
D
in their blood.
4
The
cancer rate
was three times higher for those who had less than the amount of vitamin D in the blood equivalent to an intake of 270 IU daily. The researchers examined the breast cancer and colon cancer rates in 29 U.S. cities and 20 Canadian cities and found that the greater the
amount of sunlight-blocking
the breast cancer and colon cancer rates.
air pollution, 4
the higher
CANCER PREVENTION AND NUTRITIONAL THERAPIES
82
Dr. Garland's research group also reported a threefold increase in
what was formerly low sunshine levels. We will again discuss the roles of vitamin D and calcium in Chapters 19 and 20 on Breast Cancer and Colon Cancer respectively. Researchers can find a good review of vitamin D and mechthe incidence of breast cancer in the republics of called the Soviet
Union, where there
1
are
anisms for cancer prevention in reference
7.
Calcium
We
know
don't really
vitamin
D
if it is
the vitamin D, the calcium, or both
and calcium working together
that
the major protective factor could be calcium,
is
protective. Since
let's
look
at
some of
the supporting evidence.
Dr. Cedrick Garland presented his evidence to Drs. Martin Lipkin and Harold
Center in
Newmark
New York
ing persons
at
high
Memorial Sloan-Kettering Cancer and Newmark were studycolon cancer due to their family histor-
at
the
City. Drs. Lipkin
risk for
of high incidences of colon cancer.
ies
Newmark found
Drs. Lipkin and
that these high-risk persons,
before taking calcium supplements, had an unusually high rate of cell proliferation (cell division) in their colons.
milligrams of calcium carbonate daily for rate
of
cell division
Drs. Lipkin and
Newmark now
conclude that "calcium contri-
and into
stages
cells
through
tion.
lower than those required for
These
effects
all
phases of the
of cell differentiation; intercellular
concentrations of calcium that are required for ever, are
After taking 1250
to three months, the
returned to normal. 5
butes to the progression of epithelial proliferative cycle
two
cell
renewal,
how-
epithelial-cell differentia-
of calcium are modulated by interactions with
vitamin D, phosphate, and
fats,
all
of which are dependent on
dietary intake." 6
Thus, low calcium intakes cause
epithelial cells to proliferate
not differentiate (mature) to become normal proliferation,
but
it
cells.
but
Fat increases this
can be overcome with adequate calcium intake.
"Increased dietary calcium inhibits hyperproliferation of colon epithe-
VITAMIN D AND CALCUM PROTECT AGAINST SOME CANCERS Hal cells
When
induced by increased
fats
or bile acids in the colon.
carcinogens induce hyperproliferation of colon epithelial
the hyperproliferation
We
of
levels
on
the chapters
practicalities
breast cancer
adult
of
again in
this relationship
and lung cancer.
How The 1989
cells,
decreased by adding dietary calcium." 7
is
look into the
will
83
Much?
RDA for vitamin D
200 IU per day. Dr, Garland and protective. Problems from is
400 IU is both safe much vitamin D don't appear until 1,000 IU or more daily. The adult 1989 RDA for calcium is 800 milligrams per day. You may wish to take a supplement containing 800 milligrams of suggests that
too
calcium (elemental) in addition to the calcium in your normal
diet.
References 1.
"Natural vitamin
(March 2.
D
helps reduce risk of cancer," Nutrition
Week
1990) 20(9):8.
1,
Cedrick
D
F.
Garland and Frank C. Garland,
"Do
reduce the likelihood of colon cancer?"
sunlight and vitamin
International Journal of
Epidemiology (1980) 9(3):227-31. 3.
Cedrick risk
F.
Garland
et
al.,
of colorectal cancer:
a
"Dietary vitamin
D
and calcium and the
19-year prospective study in men," Lancet
(Feb. 5, 1985) 1(8424) :307-9. 4.
Marilyn
Elias,
D
"Vitamin
may
help beat cancer,"
USA
Today
(Jan.
26, 1989). 5.
S.
Manolagus, "Vitamin
D
and
its
relevance to cancer," Anticancer
Research (1987) 7:625-38. 6.
Martin Lipkin and Harold Newmark, "Effect of added dietary
cium on colonic
cal-
epithelial-cell proliferation in subjects at high risk
for familial colonic cancer,"
New
England Journal of Medicine (Nov.
28, 1985) 313(22):1381-4. 7.
Harold
L.
Newmark and
Martin Lipkin, "Calcium, vitamin
I
)
and colon
cancer," Cancer Research (April 1992) 52 (7 Suppl):2067s-2()70s.
84
CANCER PREVENTION AND NUTRITIONAL THERAPIES
VITAMIN D AND CALCUM PROTECT AGAINST SOME CANCERS
85
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