Nutrition and Cancer : State of the Art 0946170142, 9780946170142

Citation preview

Nutrition

_Casce: SANDRA GOODMAN

ele Bi

Nutrition

and Cancer:

State of the Art

Nutrition

and Cancer:

State of the Art

Sandra Goodman

iii

PhD.

Green Library Publications 9 Rickett Street Fulham London SW6 1RU.

Published by Green Library July.1 O25. © Sandra Goodman

1995.

Sandra Goodman asserts the moral right to be identified as the author of this work. ie SS

ISBN 0 946170

142

~=

«+

a

AS

Printed in the United Kingdom by Fisher Print Services, Hailsham,

UK BN27 2BY.

All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical or otherwise, without the prior permission of the publishers.

This book is issued for information purposes only and Green Library makes no representation or warranty as to the suitability of any product or therapy mentioned herein for any particular individual or that the products or therapies have the effects described.

iv

CONTENTS Preface

ix

Introduction

Chapter

1:

Nutrition and Cancer: Success is a Well Kept Secret

Chapter 2:

Vitamin

Chapter 3:

Vitamin A/Beta Carotene: Role in Cancer Prevention Treatment ;

16

C: The Irrefutable Evidence

26 and

Chapter 4:

Vitamin E: The Anti-cancer Tocopheral Family

37

Chapter 5:

The Role of Selenium, Acid and Vitamin B12

Zinc, Folic

47

Chapter 6:

The Role of Essential Fatty Acids

58

Chapter 7:

Nutrition and Cancer: Critique of the Research Methodology and Evidence

71

Chapter 8:

Dietary Regimes for Cancer: Their Rationale and Efficiency Examined

85

Chapter 9:

Efficacy of Diverse Cancer Treatment Substances

96

Chapter

10:

Cancer and the Mind: Psych-neuro-immunology

107

Chapter

11:

Cancer Life and Death: Statistics, Nutrition and

117

Molecular Biology Index

128

DEDICATION

I dedicate this book to my parents who have stood by me

through thick and thin, to members

of my family who

have struggled with and died from cancer, and especially

to my cousin Elaine, who fought so courageously and was an inspiration and shining example to all who knew her. “

ACKNOWLEDGEMENTS I am grateful to the Bristol Cancer Help Centre for having commissioned me to compile the Nutrition and Cancer Database, to the Journal of Alternative and Complementary

Medicine

for asking

me

to write

the

series of articles of which this book is a compilation, and for being so reasonable to deal with throughout the series and thereafter in publishing this book. I am also appreciative of the warm wishes received from JACM readers, and the fabulous moral support always provided by my partner Mike.

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PREFACE

Richard

A. Passwater,

Ph D.

Nutrition and Cancer: State of the Art will save countless

lives and reduce needless suffering by bringing the latest health advances to the attention of both health professionals and the public. the precise information that This vital information may manner not directly intended

Here, many readers will find will be life-saving to them. also serve humanity in a by Dr. Goodman. The facts

in this book, gleaned from many thousands of scientific and medical articles, may become the database used to prevent the political blunder that could otherwise take away free access to the effective nutrients that the public needs for optimal health. Thus, this book is doubly timely, firstly because it presents life-saving information to readers and secondly because it presents information that the public can call to the attention of the Ministry of Health to dissuade them from allowing the United Kingdom to downgrade its health policies to the lowest common denominator of the EC where dietary supplements are

often restricted to ineffective dosages. In Nutrition and Cancer: State of the Art, Dr. Goodman succinctly condenses over 5000 scientific and medical research reports on nutrition and cancer alone. This is no easy task but Dr. Goodman clearly distils the important

facts from the background information with sufficient ix

detail and references to satisfy professionals without too much information to confuse or bore the general reader. Unfortunately, too many physicians in practice are unaware of the extensive depth of evidence about nutrients preventing and alleviating many deadly diseases. These reports are beginning to trickle down to the practising physicians but they often have the feeling that this research is only elementary, fragmentary and not meaningful. This misconception is largely due to the fact that medical school curricula have little involvement with nutrition as almost all of the available time is allotted to

basics, drugs and:surgery. Nutrition and Cancer: State of the Art will be a fascinating guide to the practitioner who wishes to enter the new nutrition and health information superhighway. Through her professional newsletters and scientific articles, Dr. Goodman Jjhas raised the awareness of many health professionals as to the experimentally-

increasing evidence of the role of nutrients in health. When

one considers the many

contributions

scientific and medical

of Dr Sandra Goodman,

two of the most

important are her scholarship and ability to educate both professional and public alike. In this book, she continues to break new ground as she did so effectively in Vitamin

C: The Master Nutrient. Examples of this new ground includes her discussion of the role of Coenzyme Q-10 in

overcoming

breast

cancer,

adjunct

and

alternative

therapies and many other newly discovered relationships between food components and cancer.

This book is aptly named because her research keeps her

at the state of the art and she integrates the new knowledge

from the research frontiers into the core of existing knowledge in a manner that clarifies so well the steps that

must be taken by individuals. This is a strong point of the

book. Her entire approach is 'person-centred', She does x

not advocate imposing a dietary regime on patients in the

manner that practitioners often impose drug or surgical treatments. Since every person is unique by virtue of his/ her genetics, personality, biochemistry and life style, she teaches

the reader

how to adapt the latest research

findings to each individual.

Richard A. Passwater,

Berlin, Maryland USA.

Ph. D.

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Introduction

Ihe Role of Nutrition in the Prevention and Treatment of Cancer - prosaic and academic text of some scientifically dry and little-read tome - or the subject of international

drama, political, scientific and financial intrigue?

The answers to this somewhat rhetorical question, contained within, attempt to offer a balanced and considered view of both science and intrigue to the reader. For it has been the reluctant discovery of the author that nothing regarding the subject of cancer can ever be regarded as banal.

With rates of cancer incidence rising, mortality rates not alling, and an ever increasing armamentarium of highech

scanners,

radiotherapy

equipment,

and

shemotherapeutic drugs being directed in what sometimes appears as a losing battle, there is no more emotive nor scientifically charged issue than cancer. Moreover, not mily is this the case today, on the verge of the 21st

sentury; sadly, this applied equally to many of the battles against promising cancer cures early in the 20th century!

There is nothing more discouraging to the idealistic and 1opeful researcher than to learn of the courageous 1

Nutrition and Cancer - State of the Art

discoveries thwarted

and innovations

of pioneering

scientists

by the attempts of established political and

financial organisations to protect their positions. It is even more soul destroying to read lengthy, extensively documented and scholarly historical renditions describing such battles against worthy and revered innovators including Nobel laureate scientist Linus Pauling, compassionate

doctors such

as Emanuel

Revici, Max

Gerson and distinguished scientists Stanlislaw Bryznski and Burton Lawrence.:i- But hopefully, out of such disappointed hope and trust will emerge a level-headed and realistic view of the _real worlds of government, finance and market interests outside the laboratory.

The content for this book arose from the author's commission in 1993, by the Bristol Cancer Help Centre (BCHC), to compile a comprehensive database of

publications

regarding the role of nutrition

in the

prevention and treatment of cancer. A systematic search of the MedLine database was conducted and some 3000 published articles were classified and keyed into a database on a PC housed at BCHC.

These articles included: epidemiological studies citing evidence from around the world regarding the importance of nutrition and diet in assessing risk and contributing factors to many cancers; laboratory and animal studies

investigating, at the molecular, biochemical and clinical levels, the role of many nutrients in preventing and treating a variety of tumours; animal and human clinical studies and trials using nutrients and nutritional analogues again in the prevention and treatment of a wide variety of cancers. These studies, assembled together, represented a massive international research effort, over

several decades, to investigate and begin to utilise nutrition in the quest to understand and gain mastery over the seemingly maniacal and psychopathological scourge of cancer.

Introduction

So far so straightforward. A massive amount

of data,

sublished by pre-eminent scientists, published in the most prestigious journals, so why the bother? Because of

fhe huge gap between this mass of published data aighlighting the importance of nutrition, and the prevailing medical paradigm surrounding cancer today, which in its otal non-acknowledgement-of nutrition, appears to be divorced from its own distinguished research scientists.

—=

And herein lies the rub, so to speak. The data speak for hemselves - the problem is that nutrition is consistently | gnored by the majority of cancer specialists, whose © ypinions and views often expressed to their patients

‘ange from patronising to those who wish to use nutritional nethods in their cancer treatment protocol, to vociferous and over-zealous protestations of the inherent worthlessness and quackery of nutrition in cancer reatment.

Since there are never any guarantees regarding the yutcomes of any cancer treatment, including nutritional egimes, the view of the author is that, informed by the Widest possible source of research, the cancer should decide how they wish to participate in the of their own treatment. A wide reading of the iterature reveals that some "terminally ill" patients

patient course cancer survive

xy seemingly changing nothing in their lives, while others vho try every treatment in the orthodox and/or complementary/ spiritual realm, die despite their efforts. \t present, who lives and who dies and why is simply not cnowable to those not possessed of some supernatural

ntelligence, not available to the author. tow this book came

about represents a process driven,

10t as is so often the case, by the intention to produce a 900k, but rather by the desire to inform students and yractitioners of complementary medicine of the magnitude

if the body of published research extant regarding the fficacy of nutrition in the.prevention and treatment of 3

Nutrition and Cancer

- State of the Art

cancers. In fact, this book was originally commissioned as a major series of articles by the International Journal of Alternative and Complementary Medicine, which

appeared starting in December 1993 and which ran until Autumn

1994. Each article covers a major research topic,

with the intent to summarise the leading edge of knowledge, and to introduce readers to the considerable literature in

the field. If, as a result of this arrangement, some discontinuities persist, it is for the reason that each article was intended to be self-contained. The subject matter is fairly wide-ranging, encompassing research methodology, the considerable psychological and spiritual "mind-body-spirit" literature of cancer, and thus perhaps oversteps the narrowly defined boundary of nutrition as usually understood. Perhaps. But in dealing

with people with cancer, gne.can never disentangle the emotional or psychological from the physical. And, in attempting to piece together what is reproducibly efficacious from a maverick response, it would be incomplete to assemble a research body of nutrition without examining how some people survive cancer without using nutrition, or for that matter, any other treatment approach.

References te

Richards E. Vitamin C and Cancer: 1991.

Ph Se

4.

{5},

Medicine or Politics?. MacMillan.

Houston RG. Repression and Reform in the Evaluation of Alternative

Cancer Therapies. Project Cure. 1989. Bryant B. Cancer and Consciousness: Expanding Dimensions for the Prevention and Treatment of Cancer, Sigo Press. 1990. Moss RW. Cancer Therapy: The Independent Consumer's Guide to NonToxic Treatment & Prevention. Equinox Press.1992.

Moss RW. The Cancer Industry: The Classic Expose on the Cancer

Establishment.

Paragon House.

1989.

a

Chapter 1

NUTRITION AND CANCER: SUCCESS

IS A WELL-KEPT

SECRET

‘or the past year, I have been surrounded by some 5000 Abstracts of published research, from the past decade, in he field of nutrition and cancer, of which 3000 have been sompiled into a database at the Bristol Cancer Help Sentre.: Other research delved into the historical archives

jescribing geniuses who developed cancer treatments

Which were denounced, the individuals (doctors and scientists) litigated, closed down or struck off, and the

rehabilitation"

of these treatments

later on by other

-steemed colleagues within the medical profession.2

Xesearch related to Nutrition and Cancer is mega-funded nternationally and concerns the identification of cancer-

‘ausing agents, the prevention of cancer by diet and 1utritional supplementation, and protection from and reatment of cancers by individual or combinations of 1utrients and with nutrients in combination with onventional chemotherapy and radiotherapy treatments.

3 meals ci.

daily (vegetable soup,

~

Coffee enemas every three to four hours.

diet,

salad, potatoes

Additionally, some patients receive iodine supplements. Raw liver juice, formerly a feature of this programme has been discontinued due to bacterial and parasitic contamination of commercially-available supplies of liver.

From the foregoing articles in this series attesting to the significant anti-tumour

and anti-oxidant properties of

fruits, vegetables, Vitamin A and beta-carotene, it is clear that consuming large quantities of freshly prepared fruit

and vegetables would provide cancer patients sustenance which is both therapeutic and healing. Coffee enemas, 87

Nutrition and Cancer

- State of the Art

which were standard German medical practice from the 1920s, are used to stimulate the liver, the body's main

detoxification organ. Contrary to the notions sometimes advanced in an overzealous media prone to labelling practices such as drinking carrot juice and taking coffee enemas as "cancer quackery", there is actually a reasonable amount of scientific and clinical literature on the Gerson regime.s-0 An excellent account of this and virtually every other type of anticancer substance and programme, written by a distinguished expert in cancer research and the politics of suppression of non-othedox approaches, is especially

recommended as authoritative reading.1o One of the few clinical long-term studies carried out evaluating the effects of Gerson's dietary methods:

‘

found that:

Patients were in. better general condition; Patients had fewer complications and improved tolerance of radiotherapy and chemotherapy;

Cachexia (wasting) could significantly delayed;

be prevented

or

There was reduced demand for pain killers and

psychotropic drugs;

Existing liver metastases

progressed

more

slowly with reduced tumour effusions.

An evaluation of case histories of 149 Gerson clinic patients was carried out by physicians at Maudsley and Hammersmith hospitals. Of 27 patients with independent

documentation, 20 were disregarded as "non-assessable" because they had received conventional therapy at the same time. Of the 7 cases evaluated, 3 (43%) were in

88

Rationale for dietary regimes complete remission. Amongst the findings as published

in The Lancetiz were the following:

~

Patients exhibited high ratings for confidence and mood;

:

Patients felt that they had a significant degree of control over their health;

*

Patients had low pain scores and low pain relief requirements, despite their extensive metastatic

disease;

‘i

Although there was little objective evidence of an anti-tumour effect, definite tumour regression was documented in a few patients;

rs

In view of a "fighting spirit" which correlates with better prognosis, the Gerson patients' sense of well-being could be a significant factor in the

clinical management of their disease.

The above clinical studies and evaluation in no way constitute definitive proof of the clinical efficacy of the

Gerson dietary regime in the treatment of cancer. The only rather implausible way to gather such evidence would be to conduct a large trial of cancer patienfs who are randomised to a particular regime and who would be equally motivated to follow whatever regime they were

assigned to - a highly improbable exercise! Nevertheless, in light of research from the past few decades attesting to the significant anti-cancer properties of a diet high in

fruit and vegetables, whole grains, fibre, and low in fat, the Gerson dietary regimen would appear to score high

grades in each of those categories. 89

Nutrition and Cancer - State of the Art

Macrobioticsio13

The Macrobiotic diet, a high fibre, low fat, low animal protein diet, as part of a much larger world systematic

view, is about achieving a balance between yin at one extreme and yang at the other in every aspect of ones life.

As pertaining to food, sweet foods, alcohol and drugs are extremely yin, while meat, cheese, dairy and eggs are at

the extreme end of the yang spectrum. At the centre ofa continuum, from which the macrobiotic diet is selected, are grains, vegetables, fruits and sea vegetables. The main functions of the macrobiotic diet are: To eliminate toxins accumulated through eating excess sweet, greasy, animal and dairy foods and

alcohol, and restore healthoe eating a balanced, centred diet; To

eat foods

—, appropriate

for any

particular

geographic area and climate; in other words, diets for those living in temperate climates wouldn't include tropical foods, and those living in cold climates wouldn't eat a primarily raw diet.

The

Macrobiotic

diet

is comprised

of the

following

proportions of foods: *

Whole grains - brown rice, barley, millet, oats, corn, rye, wheat, buckwheat - 50-60 percent; Vegetables - a wide variety of locally, organically grown vegetables, including cabbage, kale, greens, broccoli, cauliflower, squash, carrrots and many more - 25-30 percent;

A variety of beans, including tofu, tempeh and

natto, and sea vegetables - 5-10 percent. 90

Rationale for dietary regimes $

Soups, especially miso soup - 5 percent. Fish, seafood, seasonal fruits, condiments and seasonings are supplements to the main diet.

The Macrobiotic diet is a non-rigid, gentle and individualised regimen, devised according to a particular person's constitution and medical condition, contrary to many popular misconceptions. Complementary are ancillary diagnostic and therapeutic disciplines such as pulse and face diagnosis, acupuncture and shiatsu, the Japanese branch of oriental medicine. Despite the small proportion of raw vegetables and fruits, there are particular aspects of the Macrobiotic diet-which have been shown to have significant anti-cancer properties:

.

*

The consumption of yellow, orange and green vegetables, usually steamed, with their abundance of beta-carotene, calcium, selenium and other micronutrients. In addition, cabbages and cruciferous vegetables contain the anti-cancer compounds indole glycosinate;14.15

Sea

vegetables

have

been

shown

to possess

significant anti-cancer properties; 1o.16.17

*

The use of soy products and fermented soy products, containing phytate, protease inhibitors and isoflavones, inhibitors of oncogenes:1s.19

*

The consumption of Bancha tea, a variety of green tea, containing a potent anti-cancer compound EGCG;20

*

The abundance of high fibre-containing whole grains and the avoidance of red meat, a known promoter of colon cancer. 91

Nutrition and Cancer - State of the Art

There has not been a great deal of clinical or scientific evaluation of macrobiotic diets;21 however, Michio Kushi, the foremost advocate of Macrobiotics has been fairly articulate in publishing the principles, philosophy and application of Macrobiotics to cancer and other health problems.22 However, as judged by promoting the major

anti-cancer dietary elements - low fat, high fibre, fruits and vegetables, low animal protein - Macrobiotics, totally different from the raw vegetable, juicing regimen of Gerson, also appears to score highly on the anti-cancer scorecard. ae. *

Other Dietary Regimes

Gerson and Macrobiotics are but two of the many dietary regimes promoted for their*‘cancer prevention and therapeutic effects. There are more extreme raw-food

regimes

such as Ann

Wigmore's

Living Foods

diet -

consumption of purely "alive" foods - sprouted, raw and uncooked vegetable foods; and more moderate "mixed" regimes such as the present-day Bristol diet, which encourages whole grains, cooked and raw vegetables,

fruits and limited amounts of animal protein and dairy products. Most such diets encourage healthy eating, emphasising fresh fruits and vegetables and whole grains, which are certainly health and life-promoting.

Nutrition - Ignored by Medics and Media During a recently televised week devoted to women's

health issues,2s there were several programmes devoted

to highlighting the anguish of breast cancer,2s and the uneven quality of medical breast cancer diagnosis and

92

Rationale for dietary regimes treatment services. In a summary round-table discussion chaired by Sheena MacDonald with a number of panelists from a variety of medical specialities, when asked what

measures could reduce the high UK breast cancer mortality figures (the highest in the developed world), the BMA spokeswoman

replied that the answer

lay in detecting

malignancies earlier through the mammogram-screening programme for woman over 50 years of age.2s Not a whisper or mention of the importance or effectiveness of nutritional measures, or the research pointing to reduced cancer risk. With hundreds of new research reports published currently, attesting in one way or another to the efficacy of various dietaryor nutritional measures in cancer prevention or treatment, it is difficult to comprehend this conspicuous omission of evidence and recommendations from such media events.

The Direction for a Person with Cancer

A diagnosis of cancer necessitates a totally unique and individual examination of all in a person's life that is important to the restoration of health to that individual. Every person's genetic and biochemical constitution is

unique, as are his or her priorities in life and most valued relationships.

There can never be any universal answer to all cancer patients. Some individuals are cured even though they make no dietary changes at all and submit to conventional medical therapy. Others go through all the conventional medical treatment and don't survive. Some people make

profound spiritual and psychological changes in their attitudes

and

live,

others

while

who

follow

every

conceivable path of nutritional, psychological and spiritual therapy die. And, while living or dying is a very arbitrary

93

Nutrition and Cancer - State of the Art assessment, quality of life is obviously of paramount importance to all of us who ultimately will die one day. The best and indeed only advice which can be profferred to cancer patients is to avail themselves of the best

information pertaining to their condition - recommended types of treatments, prognosis based upon conventional treatments, nutritional, complementary treatment options and spiritual practices which accord with their heartfelt congruent beliefs and wishes. It is very important and

vital, according to long-time experts like Dr Lawrence LeShan,2s who has worked with cancer patients for some 35 years, to do what you. want to do and what you feel is best for you. Personal accounts of those with experience

with the Gerson and macrobiotic regimes make inspiring reading. 26-27 There is a wealth of dietary.and nutritional information which seems to protect against cancer and appears to help certain people's cancer, however, there are no guarantees and insufficient evidence to know that a particular regime will help you. If you are the sort of person who hates to cook and would find paying attention to diet and nutrition a major hassle and intrusion, then there must be another way forward for you.

There are no prizes and no rules, except that you have choice.

References 1.

Articles

1-7. Series The Role of Nutrition in Cancer. JACM.

Dec-June

1994.

2.

BCHC Nutrition and Cancer Database is a comprehensive compilation of published scientific research, with Abstracts. 1993. For information,

3.

Passwater R. Cancer Prevention and Nutritional Therapies. Keats. 1993.

contact the Bristol Cancer Help Centre (01272) 743 216.

pp: 138-41.

94

Rationale for dietary regimes Gerson M. Dietary considerations in malignant neoplastic disease. Rev Gastroent; 12: 419-25. 1945. Gerson M. Effects of a combined dietary regimen on patients with malignant tumors. Exp Med Surg; 7: 299-317. 1949. Gerson M. No cancer in normal metabolism. Medizinische Klinik; 5: 17579. 1954. Gerson M. Cancer, a problem of metabolism. Medizinische Klinik; 5: 1028-32.

1954.

Gerson M. The cure of advanced cancer by diet therapy:

10.

a summary of 30 years of clinical experimentation. Physiol Chem Phys; 10: 449-64. 1978. Gerson M. A Cancer Therapy: Results of Fifty Cases. Element Books. 1958. Moss RW. Cancer Therapy - The Independent Consumer's Guide to Non-

dsl

Toxic Treatment and Prevention. Equinox. 1992. Lechner P and Kronberger L. Experiences with the use of dietary therapy

12.

in surgical oncology. Aktuelle Ernaehrungsmedizin. 2:15. 1990. Reed A et al. Juices, coffee enemas, and cancer. The Lancet; 336: 667-

13.

15.

16.

8. 1990. Bryant B. Cancer and Consciousness. Sigo Press. 1990. Albert PM. Physiological effects of cabbage with reference to its potential as a dietary cancer-inhibitory and its use in ancient medicine. J Ethnopharmacol. 9:261-72. 1983. Stoewsand GS et al. Protective effect of dietary brussels sprouts against mammary carcinogenesis in Sprague-Dawley rats. Cancer Lett. 39: 199-

207. 1988. Sokoloff B. Anticancer potential of Viva-Natural, a dietary seaweed extract,

17. 18. LO:

20.

on

Lewis

lung

carcinoma

in comparison

with

chemical

immunomodulators and on cyclosporine-accelerated AKR leukemia. Oncology. 46: 343-8. 1989. Teas J. The dietary intake of Laminaria, a brown seaweed, and breast cancer prevention. Nutr Cancer. 4:217-22. 1983. Benjamin H et al. Inhibition of benzo[a]pyrene-induced mouse forestomach neoplasia by dietary soy sauce. Cancer Res. 51: 2940-2. 1991. Messina M and Barnes S. The role of soy products in reducing risk of cancer. J Natl Cancer Inst. 83: 541-6. 1991.

Fujiki H. (-)epigallocatechin gallate (EGCG), a cancer preventive agent. Fourth Chemical Congress of North America. New York: American Chemical Society. 1991. Bowman BB et al. Macrobiotic diets for cancer treatment and prevention. J Clin Oncol. 2(6): 702-11. 1984. Kushi M and Alex J. Cancer Prevention Diet: Michio Kushi's Nutritional Blueprint for the Relief and Prevention of Disease. Thorsons. 1988. Gimme Health, Channel 4. May 1994. Breast Cancer. The Pulse. BBC] May 1994. LeShan L. Cancer as a Turning Point. Gateway Books. 1989-92. Bishop B. A Time To Heal. Keats 1985. Faulkner H. Against All Odds. Community Health Foundation 1992.

2D

Chapter 9

EFFICACY OF DIVERSE CANCER TREATMENT SUBSTANCES

\ Introduction In 1971 Richard Nixon declared "war on cancer" and, over

the past several decades, huge expenditures of resources have been expended internationally in the development of "conventional" cancer treatments, represented to date mainly by surgery, chemotherapeutic and radiotherapy regimes. As evidenced by the published cancer statistics, the war, although expensive, has not been won, amid

inestimable suffering, loss of precious life and incalculable financial consequences for all, as cancer afflicts more of us. More on the grim cancer statistics in a later chapter, which will attempt to address the issues of who lives, who dies, quality of life and survival with cancer.

An equally vigorous but much less-well known war has been waged for decades against "unconventional" cancer treatments, variably consisting of natural and/or nonpatentable substances - vitamins, minerals, herbs, immune boosters, vaccines, which have been condemned loudly by the medical establishment as ineffectual,

96

Up-and-coming treatments unproven quackery. This at-times vicious David and Golliath campaign appears to have been motivated by

avarice, greed and power, since it makes no sense viewed

from the objective scientific and medical perspective of the published research literature. Many if not most of the developers of these treatments have been eminent doctors

and research scientists who, despite having had initial success in publishing their results in the scientific literature and/or treating the patients in their clinics, have had to endure professional derision, prosecution in the form of lengthy court battles to prevent them practising or dispensing their treatments, and exile to foreign shores. The determined progress of brilliant pioneers in cancer treatment such as Drs Stanislaw Burzynski, Lawrence

Burton, Emanuel

Revici, in the face of gargantuan legal

battles to stop and destroy their treatments, is a monumental testament to theirs' and others' medical and

scientific genius and deep sense of humanity to struggle against such odds to try to alleviate suffering. There is now a burgeoning and well-documented literature grown up which traces the medical, scientific, financial and political issues which all seem to be intertwined in the history of cancer treatment.1:.2.3.4

The emergence

and systematic documentation

of the

laboratory and clinical research for these diverse unofficial

cancer treatments may signal the medical establishment and pharmaceutical industry's increased awareness and interest in the huge potential inherent in any or perhaps many of these treatments. If you can't beat 'em join 'em.

The derisive condemnation of Linus Pauling regarding Vitamin C, Max Gerson and his dietary regime and many others is beginning to give way to the pharmaceutical industry's development of patented synthetic nutritional

analogues for cancer treatment and the development by individuals and small companies

of other proprietary

products such as Cartilade (shark cartilage) and Efamol (evening primrose oil). 97

Nutrition and Cancer - State of the Art

Whether this continues, resulting in the more widespread acceptance and availability of natural forms of cancer treatments, will depend importantly upon the commitment by the international research community to rigorously research and assess the efficacy of such treatments. This chapter will attempt to provide a sample of published research from several of these treatments; justice cannot be done in this space to cover the over one hundred such potentially worthy substances. For a more comprehensive

coverage and research listings (over 500 pages), readers are enthusiastically referred comprehensive reviews.s.4

to several

excellent

and

ant

CoEnzyme Q10

The ubiquinone Coenzyme QTO is a component, along with a number of cytochromes, of the electron transport carrier system which shuttles electrons in a handshake

fashion along the energy generating pathway of aerobic metabolism. CoQ10 strengthens the cardiovascular system, normalises blood pressure and augments the immune system.

Cancer patients have greater deficiencies

of CoQ10, presumably due to general nutritional deficiencies and particular shortage of vitamins required for its biosynthesis from the amino acid phenyalanines

In Nov 1993, Knud Lockwood, Sven Moesgaard and Karl

Folkers from Copenhagen Denmark and Austin Texas,

USA reported to the Eighth International Symposium on

the Biomedical Clinical Aspects of Coenzyme Q, in Stockholm Sweden, the partial to complete tumour regression in six breast cancer patients supplemented

with doses of Coenzyme Q10 (CoQ10) ranging from 90 to 390 mg daily. This clinical data has been recently published.s Of 32 "high-risk" patients supplemented with

98

Up-and-coming treatments anti-oxidants, fatty acids and CoQ10, all survived after 2 years, and 6, aged from 48 to 82 years, had documented remissions of breast tumours. In addition, morphine dosage was reduced, metastases were not observed and clinical conditions were excellent.

In one case of 59 years, following 1 month's treatment of 390mg CoQ10, the (intraductal) tumour was no longer

palpable, mammography confirming the absence of signs of tumour. A further case with intraductal cancer showed

no evidence of tumour or distant metastases following 3 months' treatment with 300 mg CoQ10 daily. The breast cancer tumour regression may be the result of CoQ10's bioenergetic activity, expressed as the hematological and immunological activity of this vitamin. The author, who has treated about 200 breast cancer cases per year for 35 years, "has never seen a spontaneous complete regression of 1.5-2.0 cm breast tumour, and has never seen a comparable regression on any conventional anti-tumour therapy”".s It is hoped that the report of this clinical success by these oncologists will provide the impetus and justification for

more

rigorous

research

and

clinical treatment

with

CoEnzyme Q10, which appears to offer promise to women with breast cancer. Cancer is always unpredictable and clinical progress individually unique; it cannot be

cautioned strongly enough not to extrapolate from these individual remissions to magic bullet. Iscador - Mistletoe

Iscador, the proprietary (Weleda AG) fermented preparation of the European mistletoe combined with

homeopathic dosages of silver copper and mercury, approved

treatment

for

cancer

99

in

Germany

is an and

Nutrition and Cancer

- State of the Art

Switzerland, administered to some 40,000 people during

the 1980s.7 Evidence for its clinical oncology is centred upon its immune-enhancing properties: *

One active ingredient, a plant lectin called ML 1, when injected into rabbits resulted in significant natural killer cell, macrophage, and other white blood cell activity enhancement; similar immune enhancement occurs in cancer patients injected with Iscador;s

Iscador significantly stimulated the thymus gland and thymus immune‘cells, resulted in increased antibody production and B-cells, acceleration of recovery of bone marrow and spleens from irradiated animals; A peptide isolated:from Iscador decreased the size of solid lymphomas in mice;s In humans, Iscador demonstrated clinical anticancer effects: Cyto-toxicity to cancer cells and immune enhancement in patients with widespread metastatic lung cancer; Increased activity of natural killer cells, similar to that observed with interferon-alfa;

Treatment with Iscador following surgery of 25 women with ovarian cancer, resulted in a five-

year survival rate of 100%, Stage I and II, 23%, Stage III and 0%, Stage IV. Compared to patients who received the drug Cytoval and survived 5.2 months with Stage III cancer, the Iscador patients who had more advanced disease survived an

average of 16.2 months.10 100

Up-and-coming treatments

Research into Iscador's anti-cancer activity is ongoing at

the Lucas Clinic, Arlesheim, Switzerland. Hopefully the results of their research, if positive, will result in the greater availability of Iscador, particularly in America, where it has been condemned by the American Cancer Society.

Shark Cartilage Shark cartilage appears to be a promising anti-cancer

substance. Its mode of action is antiangiogenesis, the inhibition of the growth of blood vessels, which deprives tumours of their nourishment,,thereby starving them.11.12 There have been clinical successes using shark cartilage, administered rectally as described in Dr William Lane's popular book Sharks Don't Get Cancerzis

*

A woman with Stage III advanced uterine cervix cancer: following seven weeks of shark cartilage therapy, pain significantly diminished, the tumour 80% reduced in size; after eleven weeks, 100% ‘decrease in tumour size, and cessation of pain;

*

Woman with bone metastasis to the sacroiliac (previously irradiated) from a prior uterine cervix cancer. After nine weeks of shark-cartilage therapy, the tumour was reduced by 80%; after 11 weeks, the tumour disappeared;

*

Following six to eight weeks of treatment with shark cartilage, tumours were significantly reduced in size and had begun to necrose in eight women with advanced breast cancer. Tumours became encapsulated in three cases and detached and free-floating in two cases. 101

Nutrition and Cancer - State of the Art

The above cases are but a few extracts from the book. Research continues internationally to determine the efficacy of shark cartilage in cancer treatment; we all eagerly await the results.

Antineoplastons

Antineoplastons, peptides with anti-tumour activity, are found in the blood and urine of healthy persons, but are deficient in those with cancer. Since their discovery in 1967 by Stanislaw Burzynski, MD, Ph.D., research published in peer-reviewed scholarly journals have

demonstrated their efficacy against breast, lung and brain tumours in laboratory animals and humans.s.14.15.16 The disgraceful persecution ofthis genius scientist by the FDA, the Texas Attorney General, is chronicled in detail by several reliable sources.i..17 In the words of Richard Passwateri7 ".. This is what happens when you come close to curing cancer, even if you are a respected scientist and your research is confirmed by other scientists and published in the peer-reviewed scientific literature... "

Amygdalin - Laetrile

Amygdalin is a naturally-occurring glycoside (sugar moiety with another compound) found in the kernels and seeds

of apricots, peaches and bitter almonds. Laetrile is laevorotatory nitriloside, a patented, particular form of amygdalen, prepared in the 1950s by American doctors in the treatment of cancers.

The laetrile form of amygdalin 102

seems

to have

been

Up-and-coming treatments

abandoned almost from the start, hence in most instances, for laetrile read amygdalin. Research at the Memorial Sloan-Kettering Cancer Center during the 1970s by Dr Danematsu Sugiura demonstrated that amygdalin:

Inhibited lung metastases in mice: 21% in treated mice compared with 90% in controls;

Improved their health and general well-being;

Halted the growth of small tumours temporarily.1s

There then ensued a public battle over the branding of amygdalin as ineffective, when in 1977 the then assistant director of public affairs and science writer at Sloan

Kettering,

Ralph Moss Ph.D., accused Sloan Kettering of

covering up positive results of amygdalin. Subsequent clinical research which did not reproduce these results,19 a clinical trial by Charles Moertel at the Mayo Clinic,20 and reports of cyanide toxicity,21 have been severely challenged by Dr Moss,2 but unfortunately research came to a virtual

standstill following the debacle in the late 1970s. In the words of Dr Richard Passwater "... what journal would be brave enough to risk losing advertisements and readers if it did publish on laetrile? After all, the laetrile debates and the freedom of choice movements were the most emotional issues in health care in the 1970s..."17 In the 14 research publications regarding laetrile/ amygdalin found in the Bristol Cancer Help Centre's database.22 only 2 were published after 1982, and both of these were editorial-type condemnations about quackery and questionable nutritional practices.

103

Nutrition and Cancer - State of the Art

Conclusions

In an ideal world, the way ought to be clear for a properly

conducted investigation of the potential efficacy of laetrile/ amygdalin in the treatment of cancer. In the real world, however, laetrile's more likely fate is to be confined to the dustbin of lost opportunities, along with other promising treatments such as germaniumzs and cesium chloride.24.25 Another hotly contested and controversial treatment is Immuno-Augmentative-Therapy (IAT), developed by another persecuted genius, Lawrence Burton, Ph.D, who has also been driven to-practise outside the US to the

Bahamas. Prior to yet another public debacle,s Burton's research had journals.26.27

also

been

published

in mainstream

Another revered physician and scientist, Emanuel Revici, MD, (now deceased) classified patients by metabolic type and administered anabolic or catabolic treatments in the form of various lipidic compounds and also used selenium compounds.28 For those interested in the nitty gritty details of the above battles, the Dr Moss above is the same author of two recently published exhaustive and authoritative reviews of the cancer industry and unconventional cancer treatmentsz,< It is to be fervently anticipated that research

investigating the efficacy of all treatments will be conducted fairly, without the past blatant prejudice, financial and political interests which disgrace the reputation of

scientific and governmental bodies and condemn cancer patients to wait longer and die sooner.

104

Up-and-coming treatments

References

Houston RG. Repression and Reform in the Evaluation of Alternative Cancer Therapies. Project Cure. 1989. Moss RW. The Cancer Industry - The Classic Expose on the Cancer Establishment. Paragon House. 1989. Moss RW. Cancer Therapy - The Independent Consumer's Guide to NonToxic Treatment and Prevention. Equinox Press. 1992. Lerner M. Choices in Healing. MIT Press. 1994. Folkers K et al. Vitamins and Cancer Prevention. Wiley-Liss: 103-110. 19g Lockwood K et al. Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochem Biophys Res Commun. Mar 30 1994. 199(3): 1504-8. Holtskog R et al. Characterization of a toxic lectin in Iscador, a mistletoe preparation with alleged cancerostatic properties. Oncology. 45: 172-9. 1988. Hajto T et al. Modulatory potency of the beta-galactoside-specific lectim from mistletoe extract (Iscador) on the host defense system in vivo in rabbits and patients. Cancer Res. 49: 4803-8. 1989.

105

Nutrition and Cancer

10. Wale

12.

14.

15.

- State of the Art

Kuttan G et al. Isolation and identification of a tumour reducing component from mistletoe extract (Iscador). Cancer Lett. 41: 307-14. 1988. 10. Hassauer W et al. What prospects of success does Iscador therapy offer in advanced ovarian cancer? Onkologie. 2: 38-36. 1979. Brem H and Folkman J. Inhibition of tumor angiogenesis mediated by cartilage. J Exp Med. 141: 427-39. 1975. Folkman J. The vascularization of tumors. Sci Am. 234: 58-64. 1976. Lane IW and Comac L. Sharks Don't Get Cancer - How Shark Cartilage Could Save Your Life. Avery. 1992. Burzynski S and Kubove E. Initial clinical study with antineoplaston A2 injections in cancer patients with five years' follow-up. Drugs Exp Clin Res. 13S: 1-12. 1987. Eriguchi

N et al. Chemopreventive

effect of antineoplaston

urethane-induced pulmonary neoplasm in mice. Ther. 23: 1560-65.

16.

on

1988.

Hashimoto K et al. The anticancer effect of antineoplaston Al0 on human breast cancer serially transplanted tq athymic mice. J Japan Soc Cancer

Ther. 25: 1-5. 1990. 17%, 18.

AlO

J Japan Soc Cancer

Pee

Passwater RA. Cancer Prevention and Nutritional Therapies. Keats. 1993.

21.

US Congress, Office of Technology Assessment (OTA). Unconventional cancer treatments. Washington, DC: US Government Printing Office, 1990. Stock CC et al. Antitumor tests of amygdalin in spontaneous animal tumor systems. J Surg Oncol. 10: 89-123. 1978. Moertel CG et al. A clinical trial of dmygdalin (Laetrile) in the treatment of human cancer. N Eng J Med. 306: 201-6. 1978. Beamer WC et al. Acute cyanide poisoning from laetrile ingestion. Ann

22.

Emerg Med. 12: 449-51. 1983. Bristol Cancer Help Centre Nutrition

20;

23. 24.

25. 26.

Zila

and Cancer Database is a comprehensive compilation of over 3000 published scientific research articles with abstracts available for about 80% of the records. 1993. For information, contact the Bristol Cancer Help Centre (01272) 743 216. Goodman S. Germanium - The Health and Life Enhancer. Keats. 1988. Sartori HE. Nutrients and cancer: an introduction to cesium therapy.

Pharmacol Biochem Behav. 1: 7-10. 1984. Sartori HE Cesium therapy in cancer patients. Pharmacol Biochem Behav. 1: 11-3. 1984. Burton L et al. Isolation of two oncolytic fractions from mouse leukemic tissue. Proceedings of the American Association for Cancer Research. 3: 308. 1962. Friedman F et al. Necrosis liquefaction and absorption of C3H mammary tumors resulting from injection of extracts from tumor tissue. Proceedings

of the American Association for Cancer Research. Abstract No. 78. 6: 20. 28.

1965. Bryant B. Cancer and Consciousness: Expanding Dimensions for the Prevention and Treatment of Cancer. pp: 145-62. Sigo Press. 1990.

106

Chapter 10

CANCER AND THE MIND PSYCHO-NEURO-IMMUNOLOGY Introduction As has become

apparent from the preceding chapters,

there is a wide continuum of opinion among professionals regarding the role of nutrition

health in the

prevention and treatment of cancer, as has been elaborated in chapter 7.1 This spectrum of opinion ranges from practitioners and researchers who point to published evidence that diet and nutrition may play a major role in cancer prevention, formation and treatment, to other health professionals

who, while begrudgingly accepting that eating more fruits and vegetables may protect certain individuals from getting cancer, nevertheless feel that much of the epidemiological evidence is unclear, that the entire issue of nutrition

in cancer

prevention

and

treatment

is

controversial, and that much of the nutritional data can be alternatively explained in terms of genetic susceptibility, lifestyle and social class of certain populations. While the debate and the research continues at a relentless pace, nutrition is certainly not presently considered by

107

Nutrition and Cancer - State of the Art

the mainstream medical profession as a treatment option for cancer, although serious attention is being given to research findings of the vitamin and mineral antioxidants and the role of fibre and fat in cancer prevention and development respectively. As a scientist who has pored over thousands of research articles relating to the role of nutrition in the prevention and treatment of cancer, I cannot but be persuaded of nutrition's bona fide role, even if I must accept the complexity, imperfection and incompleteness of the present research evidence.

On an almost parallel continuum to the nutrition-cancer story has been the unravelling, over the past few decades, of the mind-immune-cancer connection. The strides made within an incredibly short time by researchers elucidating the mechanisms of psycho-neuro-immunology have succeeded in placing psychological approaches to stress management at the forefront of cancer treatment - in the management of nausea from chemotherapy (visualisation, relaxation),2 pain control (visualisation, hypnosis),s and living with cancer (psychotherapy, counselling).«

Some of the giants in this field who are almost household names, by virtue of their best-selling books include: the pioneering Carl and Stephanie Simontons and James

Creighton who developed structured programmes of relaxation and visualisations for cancer patients;s the compassionate and gifted psychologist /psychotherapist Lawrence LeShan who, with 35 years' experience working with cancer patients writes about inspiring outcomes in cancer patients who find out and do what makes them

happyss

Bernie Siegel the compassionate doctor who writes lovingly of exceptional patients and the will to live:7 David Spiegel

whose

far-sighted

research 108

in many

areas

of the

All in the mind

psychological aspects of cancer has demonstrated the benefits to survival of participating in support groups.s The Stress Immune

Connection

But the idea that the mind could influence the immune system would have been considered far-fetched even as recently as twenty years ago, when "the two disciplines of immunology and neurobiology were entrenched in their separate university departments: immunologists poking at blood cells in test tubes and dishes; nerves in frogs and squids..." And, according to David Felten, neuroscientist, University of Rochester, "the two camps would rather use each other's toothbrushes than use each other's

terminologies".s Robert Ader, studying conditioning in rats in the 1970s, fed them the horrible-tasting drug cyclophosphamide along with saccharin, with the experimental intention that the rats would associate the saccharin with the nasty taste and learn to dislike the saccharin even without the cyclophosphamide. What happened was more dramatic than mere dislike. The rats died - the more saccharin they

drank the faster they died. Ader, a psychologist, not an immunologist, who didn't know "that there weren't any connections between the brain and the immune system"s reasoned that the rats had associated the saccharin with the immune-suppressant drug. Somehow they were able to suppress their immune system to the extent that they died. In the intervening decades, Ader and others have fleshed out many details of how immune cells - B-cells, T-

cells, natural killer cells, macrophages - communicate with the brain.1o-12 A thorough review of the literature on all aspects of the mind-body connection in cancer, describing the findings of each publications, is included in David Spiegel's recent book.s

109

Nutrition and Cancer - State of the Art

The Research

Evidence

The notion that stress exerts its adverse effects upon our health has entered popular culture in an all-pervasive

way. Terms like "stressed out", "chill-out", "freak-out", "burn-out", "adrenaline buzz", flight-or-fight", testify to the widespread general knowledge that the direct or indirect effects of stress can cause heart attacks, exacerbate pre-existing health complaints (arthritis, allergies, headaches), lead to depression or even be a factor in the onset and/or the outcome of cancer. Tables

have been compiled scoring stress factors including divorce, moving house, changing jobs - the higher your tally, the more likely it is that you may suffer a major illness. There has been a considerable amount of research which has studied the interactions between various factors - personality traits, bereavement, isolation, marital status, support networks - and the onset and outcome of

many illnesses including heart disease and cancer.1s-19 David Spiegel's bibliography is highly recommended as a reference source to much of this published literature.s In addition to the research at the psycho-social level,

there is now a greatly burgeoning body of published evidence which documents at the biochemical and even molecular level, how and to what extent, states of mind such as anxiety, depression and anger affect the

functioning of immune cells - T-cells, B-cells, natural killer cells, and macrophages. Evidence showing that support networks act to buffer the physiological effects of stress,» that bereavement affects plasma levels of cortisol and the activity of natural killer cells,2: that the stress of

examinations reduces natural killer cell activity,22 and that the stress hormone prolactin accelerates the progression of prostate cancer. 23 These studies are

110

All in the mind

merely the tip of the iceberg of the extensive

body of

published research which has begun to document how

our mind and emotions affect our immune health and even our mortality.

system, our

The Mind-Body Connection

How the brain/mind/emotions communicate with the immune system is one of the hottest areas in scientific research today, which is a far cry from the derision of New Age notions of the Body/Mind/Spirit variety. Most of us are familiar with one communication mechanism which is via the endocrine system, in particular the hormone pathway from the hypothamalmus (corticotropin-releasing hormone, CRH) to the pituitary gland (adreno-cortico trophic hormone) to the adrenal medulla (hydrocortisol), where, upon interactions with T- and natural killer cells, adrenaline, growth and sex hormones act upon a complex

network of genes and alter immune excellent

reviews

detail

these

function. Several

complex

physiological

Processes.24,25

The other mind-immune system communication link, which was only recently discovered during the 1980s, is via nerve fibres interlaced between T cells, lymphocytes

and macrophages

which

are linked to ganglia (nerve

bundles) which are then connected to the spinal cord and thence to the brain.zs These nerve pathways form an integral part of the sympathetic/parasympathetic nervous

system, which, through neurotransmitters such as noradrenaline, can bind to immune cell receptors which in turn can modulate immune

function. Figure 4(overleaf)

illustrates this "dry land" communication route between the mind and the immune system.»

111

Nutrition and Cancer - State of the Art

Not only is the complexity of the mind-immune communications networks enormous; the effect of one particular chemical, say, nitric oxide, may exert contradictory effects upon different components of the immune system - slow down T-cell division (immune suppression) and kill bacteria and inhibit tumour growth (immune enhancement). Furthermore, the very same stress which may affect one person negatively, may actually ennervate or motivate another person. There thus remain a myriad of unanswered questions in this

exciting area of research. Nerve pathways tothe immune system Parasympathetic

Sympathetic

nerves

nerves

Thymus Thoracic duct

Thoracic duct

Spleen Peyer's patches (intestine)

Peyer's patches

Lymphocytes

Lymphocytes .

Lymph nodules

Lymph nodules Bone marrow

Tools for Living with Cancer There are many techniques and processes which have been put into practice and are now widely available as an

112

All in the mind

adjunct (companion) to other cancer therapies. The books

by the Simontons, LeShan, Siegel, Spiegel and Kfir and Slevin, to name but a few, are highly recommended

reading: and provide a more detailed description than can be conveyed here of the rationale for the actual processes and true-to-life inspiring stories of real people who shared their experiences of coping with cancer with others. Several of the key tenets of various psychological approaches to cancer are briefly described below.

Support and Counselling

It cannot be emphasised enough how important support groups are to cancer patients and their carers and families. Despite the concern of loved ones, and the professional involvement of physicians, there is almost a

metaphysically therapeutic process in getting together with other cancer patients, who are in the same boat, to

share feelings of anger, despair, grief, depression, hope, love. There is so much fear and unspoken terror of cancer,

death, dying and pain, surrounding cancer, and patients who can participate and share with other their honest feelings as part of such support groups actually live

longer.1s-19

Visualisation

Techniques of relaxation and visualisation have developed since first being reported by the Simontons, who used

aggressive images like sharks attacking and killing cancer cells, which, while being helpful to some, may actually

trigger negative feelings in others.s Subsequently, more positive images of relaxation, of healing, of cancer cells

113

Nutrition and Cancer - State of the Art

being carried out of the body, of pain being controlled, of calmness and serenity, in fact, images as individual as the uniqueness of each person, have been and are being used for a wide number of purposes: controlling pain, nausea, immune enhancement, stress reduction. The techniques of relaxation which were pioneered by The Bristol Cancer Help Centre in the 1980s are now widely used and are presently available within cancer treatment centres within the NHS.

Living in the.Face of Death

Death and the fear of dying, especially in great pain, remains one of our'remaining unspoken taboos. It would

appear that both the medical profession and the majority of people view death as a failure of treatment, strategy, our will, our ability to control our disease. We are so bound up in the fear of death, the consequences

to our loved ones, the injustice of life cut short, grief over unrealised aspirations, that so often, all energy is channelled

in a desperate

attempt

to prevent

death.

Spiegel movingly describes how several members of various cancer

support

groups

were

able

to transmute

this

paralysing fear of death into an acceptance that they might die, and were thus able to channel their energies and their remaining time into activities which were enormously meaningful for them. Lawrence LeShan reports the inspiring stories of several cancer patients who, following the shock of the cancer diagnosis and psychotherapeutic work, were able to point their lives in a more meaningful direction. In some cases, their cancer went into remission and these individuals lived many years longer.e

114

All in the mind

Concluding Remarks The point is that we are all humble in our ignorance of why and how certain strategies appear to work and certain cancer patients survive, and why they don't with other people. It is evident that our will, our physical and

emotional strengths and weaknesses and the treatment regimens selected all play a complex interrelated role in our outcome, not only in cancer, but in all areas of life. What appears to be most critical to our health, happiness

and well-being is that we make

individual heart-felt

choices into how it is that we can best live in ways that honour our own needs, so that our life is fully lived. In this

way we can all try to achieve an enhanced and meaningful quality of life. ;

References 1.

2.

3. 4.

5. 6.

Goodman

S. Nutrition and Cancer:

Critique of the Research Methodology

and Evidence. JACM. pp: 15-17. June 1994. Vasterling J et al. Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy. J Behav Med. Feb 1993. 16(1):65-80. Spiegel D and Sands S. Pain management in the cancer patient. Journal of Psychosocial Oncology. 6: 205-16. 1988. Kfir Nand Slevin M. Challenging Cancer: From Chaos to Control. Routledge. 19ST: Simonton OC, Matthews-Simonton S and Creighton JL. Getting Well Again. Bantam. 1978. LeShan L. Cancer As a Turning Point. Gateway Books. 1989.

M15

Nutrition and Cancer - State of the Art

Siegel BS. Love, Medicine & Miracles. Arrow. 1986. Spiegel D. Living Beyond Limits: New Hope and Help for Facing Life-

10.

12.

13.

Threatening Illness. Vermillion. 1993. Mestel R. Let Mind Talk Unto Body. New Scientist. 23 July 1994. Pg 26ole Ader R., ed. Psychoneuroimmunology. Academic Press. 1981. Ader R, Felten DL and Cohen N, eds. Psychoneuroimmunology. 2nd edition. Academic Press. 1991 Ader R, Felten DL and Cohen.Interactions between the brain and the immune system. Annual Review of Pharmacology and Toxicology. 30: 561-602. 1990. Berkman LF and Syme SL. Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents. American Journal of Epidemiology. 109: 186-204. 1979. Derogatis LR, Abeloss MD and Melisartos N. Psychological coping

15.

16. Lt.

18.

mechanisms and survival time in metastatic breast cancer. JAMA. 242: 1504-8. 1979. Sat ae Fawzy IF et al. Malignant melanoma: Effects of early structured psychiatric intervention, coping, and affective state on recurrence and survival six years later. Archives of General Psychiatry. 50: September. 1993. Goodwin JS et al. The effect of marital status on stage, treatment, and survival of cancer patients. JAMA. 258 3125-30. 1987. Kennedy S, Kiecolt-Glaser JK and Glaser R. Immunological consequences of acute and chronic stressors: ‘mediating role of interpersonal relationships. British Journal of Medical Psychology. 61: 77-85. 1988. Spiegel D, Bloom JR, Kraemer HC and Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. ii: 888-91.

Me)

20.

21;

22. 23.

24.

25.

26.

1989.

Richardson JL, Shelton DR, Krailo M and Levine AM. The effect of compliance with treatment on survival among patients with hematologic malignancies. Journal of Clinical Oncology. 8: 356-64. 1990. Levine S, Coe C and Weiner SG. Psychoneuroendocrinology of stress: A psychobiological perspective. In Psychoendocrinology. Eds. Brush FR and Levine S. Academic Press. 1989. Irwin M Daniels M, Risch SC, Bloom E and Weiner H. Plasma cortisol and natural killer cell activity during bereavement. Biological Psychiatry. 24: 173-78. 1988. Kiecolt-Glaser JK, Glaser R et al. Modulation of cellular immunity in medical students. Journal of Behavioral Medicine. 9: 5-21. 1986. Webber MM. Prolactin in the etiology and progression of human prostate carcinoma. Proceedings of AACR. 27: 222. 1986. Madden KS, Felten SY, Felten DL, Felten PR et al. Sympathetic neural modulation of the immune system. 1. Depression of T cell immunity in vivo and vitro following chemical sympathectomy. Brain, Behavior, and Immunity. 3: 72-89. 1989. Rose RM. Overview of endocrinology of stress. In Neuroendocrinology and Psychiatric disorder. Eds Brown GM et al. Raven Press. 1984.

Lorton D, Bellinger DL, Felten SY and Felten DL. Substance P innervation of spleen in rats: nerve fibers associate with lymphocytes and macrophages in specific compartments of the spleen. Brain, Behavior, and Immunity. 5: 29-40. 1991.

116

Chapter 11 CANCER LIFE AND DEATH: STATISTICS, NUTRITION AND MOLECULAR BIOLOGY The person confronted with a diagnosis of cancer (and that could mean almost any of us at some time during our life) is suddenly and very often brutally thrust into a

whirlwind of having to make unsought after decisions regarding just about every detail of the next period in his or her life - potentially mutilating surgery, highly risky treatments such as radiotherapy which may leave permanent scars, or toxic chemotherapy which can produce dreadful side effects. In addition to conventional

medical treatment programmes, there may be additional choices to be made regarding adjunctive therapies, such as nutritional regimes, bodywork therapies, energy medicine, and emotional/psychological and spiritual approaches. The urgency to embark upon the most effective course of treatment is coloured by the stark

realisation that ones very survival and the well-being of ones family and loved ones may depend upon a successful

outcome. Being forced to deal with such serious matters is not the preferred option for most of us, yet many who have faced the uncertainties of life and death with cancer are very much alive and well today and an inspiration and example to others in similar situations..-s

LA7.

Nutrition and Cancer - State of the Art

Parallel Worlds of Statistics and Gambling In fact, the person with cancer has entered the world of survival statistics, risk factors, odds ratios and prognostication, a world whose language would be quite familiar to any reputable gambler or player of chance, for

a large part of the science and literature describing cancer epidemiology and treatment is steeped in weighing the side-effects of treatment with the likelihood of outcome - cures (sometimes), disease-free periods or remission (more often), or palliative treatment to optimise quality of

life when treating advanced incurable" cancers.1 Much of the discipline of cancer epidemiology is based upon collecting accurate data, maintaining precise records and calculating accurate statistics regarding the incidence of cancers, the prevalence of particular cancers and cancer mortality. This is thé Work of Cancer Registries in the UK and internationally, where each incident of cancer is entered.

As technology has changed over the decades, so have the record-keeping systems been updated from old-fashioned

filing cards to computer records (which although infinitely speeder, carries its risks in these days of computer theft and electronic failures). The system of data collection,

histological

classification

and

recording

treatment

outcomes is certainly not perfect, and creating a computer

network that recognises different coding systems and enables simultaneous access to researchers and clinicians can be a mammoth logistical and computing challenge: An

example

of data

recently

published,

showing

percentages of male deaths of different cancers, 1988-89, published by the South Western Regional Cancer Registry is shown in Figure 5. The published document from which this figure is extracted, lists every incidence, by type of cancer, for every town in the South West Region, 118

The numbers game

Figure 1 % of Male Deaths by Site: SWRHA 1988-89 Oesophagus 4%

Stomach

8%

Rectum 5%

Pancreas 4%

Prostate

Bronchus, lung 27%

as well as deaths.s Needless to say, the mountains of data

being gathered, analysed and published relating to cancer incidence and mortality are considerable, and, as is the case in every discipline, there are serious arguments

amongst "expert" statisticians and epidemiologists as to the correct way of gathering and interpreting this data.7 However, there is one point from which there is no escape - that cancer incidence is rising, and that, despite many improvements in the treatment of certain cancers, cancer mortality rates are not declining.

Statistics for Cancer Survival

Despite what criticisms may be levelled, perhaps justifiably, at the medical profession - entrenched,

unprogressive, narrow-minded, hostile to unconventional approaches (which incidentally are human traits which apply across a broad spectrum of individuals in many

119

Nutrition and Cancer

- State of the Art

professions including complementary medicine) - there is brutal honesty and no pretence whatsoever in the medical

literature describing cancer treatment,

regarding the

lottery that cancer represents in terms of patient survival.4 At the present moment in the treatment of most cancers,

survival is greatly enhanced

if the cancer is detected

early, is localised and not spread beyond the primary

tumour. A graph describing survival in relation to breast cancer severity is illustrated in Figure 6; there is an 85% survival rate at 5 years for Stage I breast cancers; at 15 years for the same group, there is still about 65% survival. Compare this to the much more sobering statistics of only a 5% survival for Stage IV cancers at 5 years, which levels out to about nil beyond 7 years. Similarly, 5-year survival

rates with Stage I cervical cancer is 80%, compared to 8% for Stage IV cancer.s Lung cancer figures are worse; Stage I - 50% 5-year survival; Stage II - 25%; Stage III - 6%. ©

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7

Dr. Sandra Goodman,

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Pu.D.

Nutrition and Cancer: STATE-OF-THE-ART This is the book for you if you are interested in seeing the scientific evidence proving the connection between nutrition and”

cancer prevention and treatment: We are bombarded from. all” sides about the crucial importance of diet to our health, yet rarely is the latest scientific research translated into such authoritative yet highly readable form as has been achieved by Sandra Goodman, Ph.D. ‘

Dr. Goodman uses as her sauree’ of information the massive research database she compiled for the famed Bristol Cancer Help Centre, containing thousands of published articles relating to

nutrition and cancer during the past decade, many of which are™ cited within this book. Additionally, she provides a comprehensive overview of other topics central to cancer, including stress, psychoneuroimmunology, dietary and herbal remedies, even recent advances in molecular biology. In examining the evidence, Dr. Goodman asks why nutrition is almost never mentioned as an adjunct to cancer tr--" ‘ent, in view of the respectable published clinical literature{