Cancer


Integrative Oncology for Clinicians and Cancer Patients

Conventional Cancer Treatment Alone Is Not Working

According to the Center for Disease Control in the USA, the age-adjusted mortality rate in the USA for cardiovascular disease and cerebrovascular diseases dropped dramatically between 1950 and 2005 while that for cancer dropped only slightly (See Figure 1, p.170). !is implies that the treatment methods for cancer have not been very e"ective during this time. Worldwide, conventional cancer treatment methods include: surgery, radiation, chemotherapy, hormonal manipulation for certain cancers and the newer monoclonal antibody targeted therapies. !e goal of cancer treatment appears to be to destroy cancer cells at all cost without much attention being paid to the health of the host, the patient. !ere is little emphasis on helping patients to make lifestyle changes or to improve their nutrition. Regarding nutritional supplements, oncologists often tell patients to avoid them, as they might interfere with conventional treatment, since radiation and chemotherapy are largely prooxidant treatments and many nutritional supplements have antioxidant properties. Oncologists often tell patients that it doesn’t matter what you eat, as long as you consume enough calories to keep your weight up while you are undergoing conventional treatments that often cause a loss of appetite. However, the adjusted mortality rates in Figure 1 show that this approach is not working very well. !e purpose of this paper is to give a di"erent perspective for treating cancer patients. Rather than just focusing on killing cancer cells, the treating physician should be able to considerably improve survival and the quality of life of cancer patients by taking a much broader view of the healing process.

Conventional Cancer Treatment Alone Is Not Working

According to the Center for Disease Control in the USA, the age-adjusted mortality rate in the USA for cardiovascular disease and cerebrovascular diseases dropped dramatically between 1950 and 2005 while that for cancer dropped only slightly (See Figure 1, p.170). !is implies that the treatment methods for cancer have not been very e"ective during this time. Worldwide, conventional cancer treatment methods include: surgery, radiation, chemotherapy, hormonal manipulation for certain cancers and the newer monoclonal antibody targeted therapies. !e goal of cancer treatment appears to be to destroy cancer cells at all cost without much attention being paid to the health of the host, the patient. !ere is little emphasis on helping patients to make lifestyle changes or to improve their nutrition. Regarding nutritional supplements, oncologists often tell patients to avoid them, as they might interfere with conventional treatment, since radiation and chemotherapy are largely prooxidant treatments and many nutritional supplements have antioxidant properties. Oncologists often tell patients that it doesn’t matter what you eat, as long as you consume enough calories to keep your weight up while you are undergoing conventional treatments that often cause a loss of appetite. However, the adjusted mortality rates in Figure 1 show that this approach is not working very well. !e purpose of this paper is to give a di"erent perspective for treating cancer patients. Rather than just focusing on killing cancer cells, the treating physician should be able to considerably improve survival and the quality of life of cancer patients by taking a much broader view of the healing process.

Integrative Oncology for Clinicians and Cancer Patients

 By utilizing a more integrative approach to cancer patients by educating and encouraging them to improve their nutrition, their sleep patterns, exercise as tolerated, exposure to sunlight (to encourage vitamin D formation, but not sunburn), improve sleep patterns and help them deal with stress, therapeutic results should be improved in terms of improved quality of life, prevention of recurrences and improved survival time in advanced cases. Evidence for the Role of Diet in Helping to Prevent Cancer A number of studies suggest that dietary factors can either prevent or encourage the development of cancer. In his book, $e China Study,1 T. Colin Campbell, outlines the #ndings of the most comprehensive study of nutrition ever conducted. Other research2-5 supports the work of Campbell who asserts that a whole food, plant-based diet helps to prevent and treat cancer and other degenerative conditions. !e elimination or marked reduction of animal-based foods will drastically cut cancer rates and improve results of cancer treatment. !e elimination of re#ned plant-based foods containing sugar, white $our and various additives is also important. He further presents evidence that an optimal diet drastically reduces the negative e"ects of carcinogens and inhibits cancer promotion. Campbell is critical of the notion of “reductionism” research in nutrition (e.g. focus on fats or proteins or carbohydrates), rather than looking at the e"ects of a whole food, plantbased diet. He claims that with reductionism research, you don’t see the forest for the trees.

 He is also critical of the fact that health care education to the public and to professionals is largely controlled by dairy, meat and processed food and drug companies. A diet that is based largely on a whole plant-based food with a variety of colors is healthful and protective against cancer. Various organizations, such as the American Institute for Cancer Research, the American Cancer Society and the National Cancer Institute, support the notion that cancer is largely preventable with an optimal, predominantly plant-based diet. Expanding on the idea of a whole food, plant-based diet, Gabriel Cousens, in his book $ere is a Cure for Diabetes, 6 suggests that when such a diet is mostly raw, the therapeutic bene#ts for preventing and reversing degenerative diseases, such as cancer, are enhanced. He points out that the therapeutic bene#ts of phytonutrients that are not damaged by heat are considerable because they may combine with transcription factors in the cell to up-regulate anti-cancer, anti-in$ammatory and anti-diabetic genes, while down-regulating transcription factors that have the opposite e"ect. Phytonutrients can function as a master switch to turn many genes on or o". !e tiny amounts of phytonutrients in food can have a large e"ect on phenotypic gene expression. A highly re#ned processed food diet that emphasizes animal based foods has the opposite e"ect. !ere is no question that anyone adopting a healthy whole food, plant-based diet will drastically reduce his or her risk of developing cancer. We see that the Japanese people, when following a traditional Japanese diet, have a relatively low incidence of some of the most common cancers such as breast, prostate and colon cancer.

 However, when they migrate to the United States and adopt the standard American diet, the incidence of these cancers goes up dramatically. Another excellent book written by a nutritionally oriented oncologist and radiotherapist Charles B. Simone, titled Cancer & Nutrition,7 outlines an extensive program to help prevent cancer. !is program involves a largely whole foods, plant-based diet, exercise program, dietary supplements and tips for stress management. It contains hundreds of references to the scienti#c literature that support his program. Not everyone agrees that a completely plant-based diet is best for everyone. Famed dentist and researcher Weston A. Price spent many years in the 1930s researching the relationship between diet and the development of degenerative disease by interviewing and examining people in many cultures throughout the world. He noted the health of the people, including careful examinations of their teeth and mouths while they ate their traditional diets and then again after western, so-called civilized diets of re#ned processed foods were introduced. His observations were striking. People who ate a wide variety of whole food diets, both animal and plant based, were extremely healthy but, once re#ned foods were introduced, health deteriorated and all kinds of chronic degenerative diseases including cancer evolved.8 Like Campbell and Cousens, the Price-Pottenger Foundation (http://www.ppnf.org/catalog/ ppnf/) advocates eating whole foods and avoiding processed foods. However, they do advocate the use of certain types of animal foods. !ey advocate the use of raw dairy products and beef from grass fed animals. !ey emphasize using organic foods and foods that do not contain chemicals. 

Another extremely valuable book entitled Beating Cancer with Nutrition9 by nutritionist Patrick Quillin, o"ers very practical information to prevent cancer with nutrition, including nutritional supplements. Quillin is also not an advocate of extreme vegan diets. !is book should be read and implemented by any clinician who is treating cancer patients. Nutritional Recommendations and Other Suggestions for Patients Diagnosed with Cancer Although many physicians would acknowledge that nutritional factors are important in preventing cancer, when it comes to treating patients who have been diagnosed with cancer, the vast majority of oncologists fail to discuss nutritional and lifestyle factors to help their patients manage their cancers. Oncologists attempt to rid the body of cancer cells with surgery, radiation, chemotherapy, anti-hormonal therapies and/or the new monoclonal medications. Little attention is paid to lifestyle factors, nutritional recommendations or nutritional supplements. Oncologists often give patients dietary advice that is exactly opposite to the advice contained in cancer-preventive diets. Patients are frequently told to eat high calorie, high fat, high protein diets that also contain lots of sugar and other re#ned processed foods. !ey are sometimes told that it doesn’t matter what you eat as long as you eat enough calories to sustain your weight during your conventional treatment. !ere is considerable direct and indirect evidence that some of the same recommendations designed to prevent cancer should also be applied to patients who already have cancer. Implementing such a program should improve cancer patient survival statistics and the quality of life of these patients, including signi#cantly reducing the side e"ects of conventional treatments. 

Both Simone and Quillin in their books cited previously have chapters showing the bene#ts of excellent nutrition for patients undergoing conventional cancer treatment with references to support their recommendations. Common sense tells us that a patient’s clinical outcome will be related to his nutritional intake. Food supplies the building blocks for all cellular structures in the body (cell membranes, DNA, proteins, etc). It supplies the calories or fuel that, when combined with oxygen in the body, supplies energy for all biochemical reactions. Finally, food supplies information to the genes of the body to help regulate all biological processes. !is epigenetic information can help the genes to repair and heal the body or cause a deterioration of the healing process, depending upon what information from food is supplied. One important area of concern for cancer patients and people in general has to do with exposure to toxins and how well the body is able to rid itself of these toxins. Toxins may be carcinogenic or toxic in other ways. We are what we eat, drink, breathe, touch, absorb and can’t eliminate. We have many systems in our body to help protect us from toxins and to help our body eliminate them. First, we have the barrier function of our skin and our mucus membranes. We eliminate many toxins through bowel movements and it is important for all us to move our bowels at least once daily. One of the main functions of the liver is to eliminate toxins. !is is generally done in two steps, with toxic organic molecules being converted to a more watersoluble form in phase one and conjugated to another organic molecule in phase two for easier elimination either through urine or feces via the bile. 

Many phytonutrients in fruits, vegetables and herbs are capable of in- $uencing various detoxi#cation pathways to help the body eliminate toxins. For example, sulforaphane derived from broccoli sprouts, up-regulates phase 2 of liver detoxi#cation and shows many anti-cancer properties.10,11 It is di%cult to #nd controlled studies comparing a group of cancer patients receiving only conventional treatment with another group that receives conventional treatment along with a dietary program that includes many of the principles of nutrition that I discuss in this article. One such study recorded the survival time from diagnosis of pancreatic cancer patients who ingested a macrobiotic diet, which consists primarily of whole, plant-based foods. In the #rst major scienti#c study of the macrobiotic approach to cancer, researchers at Tulane University reported that the 1-year survival rate among patients with pancreatic cancer was signi#cantly higher among those who modi- #ed their diet than among those who did not (17 months versus six months). !e one-year survival rate was 54.2 percent in the macrobiotic patients versus 10.0 percent in the controls. All comparisons were statistically signi#cant.12 Also, reported in this paper was a study in which prostate cancer patients were prescribed a macrobiotic diet. For patients with metastatic prostate cancer, a case control study demonstrated that those who ate macrobiotically lived longer (177 months compared to 91 months) and enjoyed an improved quality of life. !e researchers concluded that the macrobiotic approach may be an e"ective adjunctive treatment to conventional treatment or in primary management of cancers with a nutritional association. “

!is exploratory analysis suggests that a strict macrobiotic diet is more likely to be e"ective in the long-term management of cancer than are diets that provide a variety of other foods,” the study concluded. In spite of the limited number of published studies on this subject, many nutritionally oriented clinicians are convinced that an optimal nutritional program is essential for improving the results of cancer treatment and that such a program should be recommended for cancer patients and not reserved only for those without cancer who are looking to prevent it. It should also be used by patients who have undergone successful conventional treatment and are searching for ways to help prevent a recurrence. Here is a list of recommendations that I give to my cancer patients concerning dietary recommendations. I suggest they avoid: sugar and white $our products; alcohol, ca"eine, $uoridated and chlorinated water; foods containing bromine, hydrogenated fats and all trans fatty acids; arti#cial chemicals added to foods such as arti#cial sweeteners like aspartame (Nutrasweet or Equal) and sucralose (Splenda), arti#cial colors and $avors, preservatives; #sh contaminated with mercury; and genetically modi#ed food. Many people are sensitive to gluten (protein found in wheat, rye and barley) and should avoid these foods.

 Other food allergens should also be avoided. Non-dietary items to be avoided include: tobacco; recreational drugs like marihuana and cocaine; mercury amalgam dental #llings; exposures to toxic chemicals; synthetic hair dyes; aluminum containing antiperspirants; harmful electromagnetic frequencies (such as cell phones as much as possible, microwave ovens); exposure to nuclear plants; and tight #tting clothing such as wired bras, which cut o" lymphatic circulation from the breasts. A more complete list of items to avoid can be found at my website: www. schachtercenter.com (click on literature and articles and look for the “Avoid List”). My suggestions as to what to eat emphasize some of the points that have been previously made. I suggest that patients eat primarily whole foods, mostly plant-based, largely raw and preferably organic. I tell them to shop in the outer isles of the super market where most whole foods are kept and to avoid the inner isles, which largely have packaged processed foods. A wide variety of vegetables, fruits, nuts and seeds and legumes should be eaten and attempt should be made for the foods in the diet to be of many colors (a rainbow array), as this helps to ensure that a wide variety of phytonutrients are obtained in the diet. Fresh, raw, vegetable juices with a smaller amount of fruit are excellent. Animal foods, though somewhat limited, should generally be unprocessed, without chemical additives. Meat should be from grass fed animals and organic when possible. Dairy should be certi#ed raw if it is available. Eggs should be from free range chickens and organic when possible.

 For most people, I do not recommend total elimination of animal products, as advocated by Campbell and Cousens. Food should not be overcooked or burned. Additional suggestions I give to my patients include: (1) Eat slowly and chew your food well to improve digestion and prevent gastric upset; (2) Don’t skip breakfast because studies have shown that people who eat breakfast generally have a lower intake of total calories for the day and have a better insulin sensitivity; (3) Meals should not be skipped as doing so causes an increase in insulin resistance; (4) Cooking method matters, as harsh cooking methods produces carcinogenic heterocyclic amines, oxidized cholesterol, lipid peroxides and advanced glycation end products, all of which are carcinogenic; (5) It is best to boil, poach or stew foods and avoid frying, broiling and roasting; and (6) Avoid the microwave, which tends to destroy nutrients and change blood chemistries.13 If physicians caring for cancer patients helped them to improve their diets, several positive e"ects could be expected. !ese include: (1) Avoidance of malnutrition (many patients die from malnutrition, rather than the cancer process itself ); (2) Minimization of adverse e"ects from conventional treatment; (3) Optimization of cytotoxic e"ects on cancer cells; (4) Protection of healthy tissue; (5) Healthy cell proliferation; (6) Immune enhancement, helping to protect the patient against infections; (6) Bene#cial hormone changes. The Role of Hope, Attitude and Stress Management; Breathing and Energy Flow; Exercise, Sunlight and Vitamin D, Importance of Sleep and the Need for Healthy Social Relationships 1. 


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