Cancer Prevention and Nutritional Therapies ( Cancer and its Nutritional Therapies by Richard Passwater ) [Revised] 0879836075, 9780879836078

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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

DO NOT REMOVE CARDS FROM POCKET

ALLEN COUNTY PUBLIC LIBRARY FORT WAYNE, INDIANA 46802

You may or

return this

bookmobile

book

of the Allen

to

any agency, branch,

County Public

Library.

OEMCO

•

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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