Cancer and Nutrition

Next month (Oct 2009), Suzanne Somers’s new book on cancer and nutrition is expected to be released through a flurry of publicity.  The blogosphere already has a number of opinions posted on this hot topic even before the book is out!

I’ve reviewed very strong opinions from those who are for and against using nutrition as a preventive measure and treatment modality for those with cancer.  I’ve noticed that a lot of those who reject or minimize the importance of nutrition in cancer resort to name-calling.  Those who support it tend to focus on the science behind the claims.

Well, for those who’ve been following this blog, you can guess which group I’m in.  The fact that nutrition is a powerful primary factor in the development, prevention, and a necessary component in the treatment of cancer, is strongly supported by many good objective studies in the scientific literature.  Following is a list of a few of my favorite nutrient factors and how they influence cancer, with literature references:

Indole-3-carbinol

  • Indole-3-carbinol (I3C) is a compound found in high concentrations in the Brassica family vegetables, including broccoli, cauliflower, brussels sprouts, cabbage and kale.  Studies show that a concentrated dose of about 400 mg/day of I3C inhibits the growth of estrogen receptor-positive and estrogen receptor-negative breast cancer cells.
    References:
    1. Inhibition of proliferation and modulation of estradiol metabolism: novel mechanisms for breast cancer prevention by the phytochemical indole-3-carbinol Proc Soc Exp Biol Med 1997;216:246-52.
    2. Indole-3-carbinol and tamoxifen cooperate to arrest the cell cycle of MCF-7 human breast cancer cells. Cancer Res 1999;59:1244-51.
  • I3C increases the beneficial estrogen metabolites and decreases the harmful estrogen metabolites.  Many research studies show that the pathways by which estrogen is metabolized is an important etiological factor in diseases such as breast cancer, uterine, ovarian, cervical and even head and neck cancers.  To briefly explain: Estradiol undergoes oxidative conversion to estrone.  Estradiol and estrone can undergo hydroxylation by different isoenzymes, either at the 2 or 16 carbon atoms. These different metabolites have opposing effects on estrogen receptors.  The 16-hydroxyestrone metabolites are associated with cancer cell proliferative effects where the 2-hydroxyestrone metabolites are associated with antiproliferative effects on cancer cells.  Research shows statistically significant decreased risk for uterine, ovarian and cervical cancers in women with higher ratios of 2 to 16 hydroxyestrones.   Using I3C, the anti-carcinogenic 2-hydroxyestrones increases and the pro-carcinogenic 16-hydroxyestrones decreases.
    References:
    1. Antiestrogen action of 2-hydroxystrone on MCF-7 human breast cancer cells. J Biol Chem 1984;259:4840-45.
    2. A pilot study of urinary estrogen metabolites (16 alpha-OHE1 and 2-OHE1) in postmenopausal women with and without breast cancer.  Environmental Health Perspectives. 1998;106:A126-A127.
    3. Estrogen metabolite ratios and risk assessment of hormone-related cancers. Assay validation and prediction of cervical cancer risk. Ann N Y Acad Sci 1995;768:312-16.
    4. Estrogen metabolism as a risk factor for head and neck cancer. Otolaryngol Head Neck Surg. 2001;124:241-47.
    5. Dose-ranging study of indole-3-carbinol for breast cancer prevention. J Cell Biochem Suppl 1997;28-29:111-16.
    6. Long-term responses of women to indole-3-carbinol or a high fiber diet. Cancer Epidemiol Biomarkers Prev 1994;3:591-5.
  • I3C inhibits the ability of human breast cancer cells to metastasize.
    Reference:
    Inhibitory effects of indole-3-carbinol on invasion and migration in human breast cancer cells. Breast Cancer Res Treat 2000;63:147-52.

Calcium D-Glucarate

  • D-glucaric acid or D-glucarate is a substance produced naturally in small amounts by humans and mammals.  Calcium-D-glucarate is the calcium salt of D-glucarate.  Glucarate is found in many fruits and vegetables with the highest concentrations in oranges, apples, grapefruit and cruciferous vegetables (broccoli in particular).  Calcium-D-glucarate has detoxifying and anti-carcinogenic properties, due to its abilities to induce a phase II detoxification process known as glucuronidation.  Animal studies have shown calcium-D-glucarate alone, and in combination with retinoids (compounds that are chemically related to vitamin A) inhibits breast cancer cell formation by up to 70 percent.
    References:

    1. Effect of calcium glucarate on b-glucuronidase activity and glucarate content of certain vegetables and fruits. Biochem Med Metab Bio 1990;43:83-92.
    2. Calcium glucarate as a chemoprotective agent in breast cancer. Isr J Med Sci 1995;31:101-5.

Omega-3 Fatty Acids

  • Fatty acids required for maintaining human health which are not produced by the body in sufficient quantities are termed “essential fatty acids” (EFA’s).  The three groups of essential fatty acids, omega-3, omega-6, or omega-9, are all classified as “unsaturated” fatty acids.  These three have differing influences on many essential functions in the body.  Functions such as increasing or decreasing of  inflammation, closing or opening of the blood vessels, immune regulating properties, blood viscosity, and the ability of immune cells to attack cancer cells are a just a few of the functions influenced by EFA’s.  Eicosapentaenoic acid (EPA), and Docosahexaenoic acid (DHA) are the protective unsaturated essential fatty acids with good literature support for being helpful with cancer prevention.  Research studies have found EPA’s anti-tumor effect related to its suppression of cancer cell growth.  On the other hand, studies indicate that DHA’s anti-cancer effect are due to its ability to induce apoptosis of cancer cells.  Apoptosis is a natural, gentle form of cell death, which does not rupture the cell membrane and does not produce inflammation.  Thus, it does not damage nearby normal cells.  Apoptosis represents and orderly method of removing old damaged cells.
    References:
    1. Effects of fatty acids on invasion through reconstituted basement membrane (“Matrigel”) by a human breast cancer cell line. Cancer Lett 1993;75:137-42.
    2. Possible beneficial effect of fish and fish n-3 polyunsaturated fatty acids in breast and colorectal cancer. Eur. J. Cancer Prev., 1999;8:213-221.
    3. Dietary supplementation with eicosapentaenoic and Eicosapentaenoic acid inhibits growth of Morris hepatocarcinoma 3924A in rats: effects on proliferation and apoptosis. Int J Cancer. 1998;75:699-705.
    4. Cell cycle arrest and induction of apoptosis in pancreatic cancer cells exposed to eicosapentaenoic acid in vitro. Br J Cancer 1996;74:1375-83.

Vitamin D (cholecalciferol)

  • Vitamin D in humans is primarily synthesized by the effect of UV-B light exposure from the sun to the skin.  For most fair-skinned people in latitudes equal to Southern California, having about 40% of their skin exposed to sun (without sunscreen) for about 10 minutes/day in the summer to about 20 minutes/day of sun exposure in the winter is adequate to maintain optimum blood 25-hydroxy-vitamin D (25OHD) levels.  At latitudes further north, greater time in the sun is required.  Also, those with darker skin require much greater sun exposure to maintain optimal blood 25-hydroxy-vitamin D levels.  Recent research points to about 3000 to 4000 IU of vitamin D required to maintain optimal blood vitamin D levels of 40 to 65 ng/mL.  Some mechanisms by which vitamin D decreases breast cancer include:
    • arresting the cell cycle of cancer cells in the first phase
    • promoting apoptosis of cancer cells
    • potentiating responsiveness of breast cancer cells to conventional cytotoxic agents
    References:
    1. The clinical importance of vitamin D (Cholecalciferol): A paradigm shift with implications for all healthcare providers. Alt Therapies Health Med 2004;10:28-37.
    2. Mechanisms implicated in the growth regulatory effects of vitamin D compounds in breast cancer cells. Recent Results Cancer Res. 2003;164:99-110.

Anti-oxidants (used even with concurent conventional cancer therapies)

  • Most oncologists are taught in medical school that anti-oxidant supplements should not be used concurrently with conventional cancer therapies because they will interfere with treatment.  However, researchers have recently reviewed the medical literature from 1965 to 2003 regarding antioxidant use with concurrent chemotherapy. Their conclusions: “Since the 1970’s, 280 peer-reviewed in vitro and in vivo studies, including 50 human studies involving 8521 patients, 5081 of whom were given nutrients, have consistently shown that antioxidants do not interfere with therapeutic modalities for cancer. Furthermore, non-prescription antioxidants and other nutrients enhance the killing of therapeutic modalities for cancer, decrease their side effects, and protect normal tissue.  In 15 human studies, 3738 patients who took non-prescription antioxidants and other nutrients actually had increased survival.”
    References:
    1. Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 1. Alt Therapies Health Med 2007;13:22-26.
    2. Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 2. Alt Therapies Health Med 2007;13:40-47.
It will be interesting to see which of these short list of substances found beneficial in cancer prevention and treatment are mentioned in Ms. Somers upcoming book.

Dr Husbands is a Chiropractor, a Certified Clinical Nutritionist, an Anti-Aging Healthcare Practitioner and a Functional Medicine Doctor. For more information, visit http://www.holistichealthbayarea.com.