Battling Cancer

Townsend Letter for Doctors and Patients,  August, 2001  

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In the 1970s, president Nixon launched the so-called "war on cancer," a massive research effort that was supposed to find the cure for cancer. Three decades later, cancer is at least as much a public health problem as it was when the war on cancer was initiated. True, there have been some advances; for example, new drug regimens have been developed that extend the survival time of patients with colon cancer. However, despite improvements in early detection and incremental improvements in treatment, it is clear that the war on cancer has a long way to go.

Although chemotherapy is widely used as a first-line treatment for cancer, claims of its effectiveness appear to be based at least in part on questionable interpretations of the research. For example, many studies assessing the efficacy of chemotherapy compared survival rates in responders (i.e., patients whose tumors shrank after treatment) with that of non-responders (i.e., patients whose tumors did not shrink). [1] However, such comparisons are not valid, because responders may have lived longer than non-responders, even without treatment. Comparing the outcome in responders versus nonresponders, as opposed to comparing chemotherapy versus no treatment or chemotherapy versus placebo, may lead to overly optimistic conclusions about the effectiveness of chemotherapy.

A wide range of alternative treatments has also been tried over the years. These include dietary modifications, nutritional supplements (vitamin C, selenium, coenzyme Q10), pancreatic enzymes, herbal treatments (mistletoe), melatonin, visualization, immunotherapy, hyperthermia, and others. There are numerous testimonials and case reports of patients beating cancer with various alternative treatments, or through a combination of conventional and alternative medicine. However, considering the millions of people who have died from cancer, the victors are in the distinct minority. In my experience with perhaps fifty patients with "incurable" cancer who traveled to well-known alternative cancer clinics, some lived longer than they were supposed to, but only one patient survived and became cancer-free. While other practitioners may have seen better results, nearly all would agree that we have a long way to go in the fight against cancer.

Because cancer is often so difficult to treat, prevention is stifl our best bet. While cancer has a hereditary component, modifiable lifestyle and environmental factors appear to be the major contributors to cancer risk. Following is a list of choices that each of us can make in our lives, in an attempt to reduce our risk of developing cancer:

1) Don't smoke cigarettes. Smoking is the most important cause of lung cancer, and may also contribute to the development of oral cancer.

2) Avoid charbroiled, fried, and welldone meats. Excessive heating and cooking of meat leads to the formation of heterocyclic amines and polycyclic aromatic hydrocarbons, which may promote the development of colorectal cancer. Even meat cooked at low temperatures appears to increase the risk of colon cancer to some extent, but the risk is greater with more vigorous cooking methods. So, when the waiter asks you how you want your steak cooked, ask for the middle ground between E. coli and carcinogens.

3) Drink non-chlorinated water. Although the evidence linking chlorinated water to cancer is not particularly strong, there is also evidence that chlorine can increase the risk of cardiovascular disease. It seems counterproductive to try to increase our intake of antioxidants while, at the same time, consuming an oxidizing agent in our water.

4) Eat abundant amounts of fruits and vegetables. A substantial body of research has demonstrated anti-cancer effects of many different fruits and vegetables. Cruciferous vegetables (e.g., cabbage, broccoli, Brussels sprouts, and cauliflower) appear to be particularly beneficial.

5) Keep alcohol intake to a minimum. Ingestion of alcoholic beverages is associated with increased risk of several different types of cancer.

6) Exercise regularly. Exercise is associated with a reduced risk of cancer. The preventive effect may be due to an exercise-induced increase in immune function.

7) Obtain moderate amounts of sun exposure. While excessive exposure to the sun is a risk factor for melanoma, moderate sun exposure will increase the body's synthesis of vitamin D, a nutrient that appears to have anti-cancer effects.

8) Avoid food and beverage containers made of soft plastic. Compounds that leach from soft-plastic containers are known to be endocrine disrupters and could increase the risk of hormone-dependent cancers, such as breast and prostate cancer. (For details, see Berkson LD. Hormone Deception, Contemporary Books, Chicago, 2000.)

9) Take nutritional supplements. A double-blind study (see Literature Review and Commentary, page 150) showed that supplementing with 200 mcg/day of selenium from high-selenium yeast reduced cancer mortality by 50% over a 6-year period, and substantially reduced the incidence of colon, prostate and lung cancer. There is evidence that many other nutrients, including vitamin A, folic acid, vitamin C, vitamin D, vitamin E, calcium, and zinc may be protective, although not all studies agree. It should be noted that betacarotene supplements may increase the risk of lung cancer in cigarette smokers.