Search Results for: Cancer treatment

Circus, Swim, and Nails: Three Cancer Stories

Last weekend we want to see Cavalia Odysséo, a circus of horses, acrobats, and aerialists. It is a magnificent show.

Our trip to the circus began, in a way, many months ago. In March 2012, I got an email that began, “My mother has terminal cancer.”

PHD and Laurette Charron’s Cancer

The email was from Michel Charron, an aerialist with Cavalia Odysséo. Here is what he wrote:

I rushed home from Miami … to New Brunswick, Canada, to see what I could do for Mom.  The doctors say there is nothing they can do for her now….  The doctors have already decided that she is dead, and that there is nothing to be done but to keep her as comfortable as possible to the end.

She has cancer of the liver and of the colon.  They have found lesions on her lungs, which they believe are also cancerous….

When I arrived ten days ago, my mother was totally unrecognizable.  She was taking six pain pills a day, had no tone in her facial expressions, could not pronounce the letter ‘s’ properly, had severely restricted mobility, as well as difficulty concentrating and following regular conversation….

We are all alone here and would greatly appreciate some friendly advice.

I gave my cancer suggestions. The gist of my dietary advice for cancer can be found in these two posts: An Anti-Cancer Diet, September 28, 2011, and Toward an Anti-Cancer Diet, September 15, 2011. Extracellular matrix is very important, so soups and stews with connective tissue are important. Good, balanced nutrition is crucial; many nutrient deficiencies, excesses, and imbalances promote cancer. Lifestyle is very important too: circadian rhythm entrainment may be the single most important factor determining cancer prognosis.

I didn’t hear from Michel for seventeen months. Last Friday, Michel sent another email:

I contacted you last year regarding my mother, Laurette, who was diagnosed with generalized cancer and given very little time to live.  You proved a light in very, very dark times.  My mother not only lived nine months longer than predicted, but the quality of her life improved dramatically.  Thank you for that.

Cancer is a terrible disease, and had Laurette’s cancer been caught earlier there would have been hope of recovery, but Michel was grateful for the extra time he had with his mom. She got off most of her prescription medications, dropping from 22 drugs to 5, and became physically and mentally able to enjoy what remained of her life. Michel and Laurette were able to spend time together, share their love for each other, and say farewell.

It happens that Cavalia Odysséo is playing in Boston right now, and Michel invited us to the show. If you ever have a chance, it is well worth a trip. The horses – there are 63 horses in the show – are a pleasure to watch; the scenery is magnificent; and the performers superb. This trailer will give you an idea of the show:

Here is the circus tent:

cavalia 01

Michel invited us back stage after the show. Here we are with some of the performers – Michel is holding our book:

cavalia 03

With Michel and his wife and co-performer Tomoko:

cavalia 03b

Some of the horses, exhausted by the show, turn their backs to visitors:

cavalia 02

And here I am getting a lesson in aerialism from Michel:

cavalia 04

Thank you, Michel! It was a magical night.

The Big Swim

If you’ve read the jacket of our book, you’ll know that Court Wing, head trainer at CrossFit NYC, says in his blurb, “One of my best friends was on the diet while undergoing chemo and his bloodwork numbers were so good that they would have been considered average … for a person without cancer.”

I haven’t yet told the story of Court’s friend, D. Kirk MacLeod. Kirk discovered he had cancer when his colon ruptured in August 2010. He’s had multiple surgeries and chemotherapies since.

Kirk has now done something remarkable. On August 4, he swam the Northumberland Strait between New Brunswick and Prince Edward Island – an 11 mile swim. He wrote beforehand:

I really do feel like I am accomplishing the impossible… I have gone from less than 160 pounds, weak and worn from chemotherapy before Christmas (less than I weighed in high school!) and two major surgeries in February and March…to 185 pounds, fit, strong and ready to swim over 14 kilometres on Sunday, August 4th!!! I started slowly training at the beginning of June!

In July I started training “hard” under the guidance of Court Wing (my Crossfit coach from Crossfit NYC) and Max Wunderle (my swim coach of TriMax Fitness). I also had invaluable eating advice from Paul Jaminet (The Perfect Health Diet). Their help and direction has been phenomenal – I couldn’t have done it without them!

After the swim, Kirk wrote:

It was brilliant… It was hard as hell…and it was an accomplishment I never imagined….

I finished in 6 hours and 25 minutes. We figure I swam about 17 km … maybe more.

I was only cleared to train at the end of May and started training in June…I began at zero. I couldn’t even do basic exercises with weights. I wasn’t a swimmer. I had never trained in swimming.

It’s an incredible story and an incredible accomplishment. Here’s Kirk:

cavalia 05

Kirk did his “Big Swim” to benefit the Brigadoon Children’s Camp Society, a charity for chronically ill kids. If you’d like to reward his hard work, donate here through Canada Helps.

Cancer and Nailbiting

Reports from other cancer patients suggest that cancer therapies are much less toxic when patients are eating PHD. Here, for example, is Bill Rafter:

About 6 months ago I learned that I had metastatic prostate cancer. The treatment recommended was hormone therapy and targeted radiation…. The effects are a total suppression of sexual drive, hot flashes similar to those experienced by menopausal women, and the feeling that one is an old, old man…. I found the last one particularly brutal, and questioned whether I wanted treatment at all.

A friend gave me a good book on cancer, recommending an all-out approach rather than the sequential attempts favored by most oncologists. Nutrition was a major part of the approach. I then trolled my friends for books on nutrition and one commented that PHD was the best he had ever read. I am overwhelmed by what it has done for me.

After reading PHD, I immediately adopted the recommendations in full, with the exception of fasting. I then went thru 44 radiation treatments, and never felt fatigue, a common symptom. No more old man feelings, and no thoughts of quitting treatment. Hot flashes are completely gone, which really puzzles the oncologists. Everyone wants to know what stopped the hot flashes.

Of course breezing through therapy is not the same as recovering, but it is a good start. If therapies have fewer side effects, higher doses can be utilized, and treatments might be more effective.

Bill continued:

But that’s not all. Ever since grade school I have been a nailbiter. I knew the habit was caused by a chemical imbalance, rather than behavioral, but could never figure out what. But since adopting PHD, my fingernails have grown to the extent that filing them is annoying. That makes me wonder that if PHD brought my system into balance, how many other imbalanced people could also benefit.

I think a lot of people can benefit from PHD. Similar to Bill’s case, it’s rare for only one health condition to improve when diet and lifestyle are improved. Usually all or nearly all health problems improve. This suggests that poor diet and lifestyle are contributors to many diseases.

Invitation to Perfect Health Retreats

A few recent events have increased my interest in how PHD, or ancestral diet and lifestyle generally, affect cancer:

  • Shou-Ching and I have recently been asked to assist in developing the dietary and lifestyle advice for a cancer clinical trial.
  • Our Perfect Health Retreats provide a fairly controlled environment where we might be able to see and measure the effect of PHD on cancer patients. Michel told us that when he put his mother on PHD, he saw notable improvements after two weeks. So a thirty day program may be long enough to generate observable results.
  • The launch of the Journal of Evolution and Health gives a scholarly forum for communicating observations and exploring hypotheses.

As readers know, my mother died of cancer, so this is of special interest to me. I suspect that diet and lifestyle have a much bigger impact on cancer than most realize. There is shockingly little research underway into this aspect of cancer management.

To gain more insight into how diet and lifestyle may affect cancer outcomes, I’d like to invite cancer patients to come to our Perfect Health Retreats. Perfect Health Retreats are not a medical program, there is no medical treatment or advice available – just great food, an environment designed for optimal healthfulness, and an educational program teaching how to live for optimal health. So the program will not be suitable for severely ill patients.

If you’re interested in participating, please contact Paul Jaminet at paul@perfecthealthretreat.com and 617-576-1753 or Whitney Ross Gray at whitney@perfecthealthretreat.com and 910-763-8530.

An Anti-Cancer Diet

Our cancer series resumes today with some tentative advice for cancer patients. (Note: This post is designed for solid tumor cancers, not blood cancers. However, most of the advice would also be applicable to blood cancers.)

This series began with Toward an Anti-Cancer Diet (Sep 15, 2011). There we advocated trying to shift cells away from the cancer phenotype via 8 anti-cancer strategies.

Future posts will explore in detail how to implement those strategies via diet and lifestyle. Today, I’m just going to give a general overview of what I would do if I had cancer.

Eat the Perfect Health Diet

This may sound self-serving, but it’s my best advice. Our diet is designed to optimize health generally, and that’s exactly what you want to do against cancer.

I said in the introduction that cancer is a disease in which cells lose their “humanness” – their proclivity to collaborate with other human cells to create a human organism. Instead, they lose recently evolved features and “remember” an identity similar to that of our distant evolutionary ancestors from the early days of multicellular life. This regression is possible because we retain the genes of our primitive evolutionary ancestors, and silencing of only a few hundred genes may cause a human cell to resemble, genetically, bacteria or fungi.

Many gut bacteria can take on two modes of behavior – a commensal or harmless phenotype, or a virulent harmful phenotype – depending on whether their environment is benign. In beneficial environments, bacteria tend to be cooperative with their host; in harsh environments, bacteria begin to look out for their own interests “selfishly,” and begin to display virulence traits which harm their host but help them move to a better environment.

Something similar may happen with “proto-cancer” cells. In a healthy environment, they are pleased to cooperate with their host – to retain their “humanness.” But in a harsh environment, they are more likely to withdraw from their neighbors and go their own way. An abused cell is more likely to become a cancer cell.

This may sound like anthropomorphization, but the metaphor is probably sound. Bruce Ames has remarked upon the fact that almost every compound is a carcinogen in large enough doses. Why? Because any unbalanced environment is harsh, and any harsh environment makes the cell more likely to develop the cancer phenotype.

It’s not only by discouraging “cancer virulence” that a good diet helps. A healthy diet also optimizes immune function.

Immune function is highly variable. Under stress, we suppress immunity so that all the body’s resources are available to meet “fight or flight” needs. Contrariwise, peaceable happiness is stimulating to immune function. A nutrient-rich diet, savory meals, happiness, calm, restful time spent in conversation – all of these things tell the body it has no pressing concerns and that available resources can be devoted to immunity and healing.

After cancer diagnosis, from a similar medical condition, those who are under stress tend to succumb to cancer, while those who are happy, cheerful, and sociable tend to recover from it. It is believed that this difference is primarily due to improved immune function in those under less stress.

I believe that a healthy, tasty diet is also a stimulant for immune function. Make your food nourishing and enjoyable.

Specific Dietary Aspects

A few aspects of an anti-cancer diet deserve special mention. Let’s look at the PHD Food Plate:

Some aspects I would emphasize for cancer patients:

  • Safe starches. I recommend obtaining 400 to 600 glucose calories a day, mainly from safe starches. I believe it is important to avoid a glucose deficiency, since glycosylated proteins are the means of intercellular coordination, and defects in glycosylation are characteristic of the cancer phenotype. (See, eg, this paper.) You don’t want to aggravate this with a self-induced glucose deficiency.
  • Low omega-6 meats. Omega-6 fats can be very damaging to mitochondria and can promote metastasis. Our needs for them are minimal, and they are everywhere. It’s important to choose foods that minimize omega-6 levels. Among meats, prefer seafood, shellfish, and red meats; obtain eggs, milk, and organ meats from pastured and naturally raised animals. Eat tropical plant oils like coconut and palm.
  • Omega-3 and omega-6 balance. The diet should include some marine sources of omega-3 fats, like salmon or sardines.
  • Bone broth soups and gelatin (cooked collagen). Collagen is 30% of our body’s protein and forms much of the extracellular matrix scaffolding which is crucial to maintainance of tissue health. The extracellular matrix is broken down in cancer. An anti-cancer diet should be rich in cooked joint tissue, such as can be found in Ox Feet Broth soups. Vitamin C and sulfur, discussed below, are also required for collagen formation; be sure you’re not deficient in these.
  • Fermented vegetables, yogurt, and acids. A diverse portfolio of gut bacteria can be helpful to the fight against cancer by several mechanisms. Probiotic flora from fermented  foods help shield against the entry of cancer-promoting pathogens to the body through the gut; they generate by-products, like short-chain fats and vitamin K2, which have anti-cancer effects; and they can modulate immunity in a favorable direction. Acids such as vinegar and lemon juice can also favorably modify gut bacteria.
  • Vegetables, herbs, and spices.Fiber is probably beneficial against cancer. Butyrate, which is produced by gut bacteria from the digestion of many types of fiber including “resistant starch” from safe starches, has anti-cancer properties. Moreover, many vegetables and traditional herbs and spices have been shown to have anti-angiogenic effects. Foods with anti-angiogenic properties include:
    • Garlic.
    • Tomato.
    • Green tea.
    • Dark chocolate / cocoa.
    • Maitake mushroom.
    • Bok choy.
    • Kale.
    • Many berries.
    • Cherries.
    • Ginseng.
    • Turmeric.
    • Oregano.
    • Parsley.
    • Polyphenol-rich extra virgin olive oils.
  • Organ meats and egg yolks. It’s important to be well nourished, and organ meats like liver and egg yolks tend to be rich in micronutrients. They are much better than plant foods for compounds like phospholipids. In particular, choline (and its phospholipid form phosphatidylcholine) is important for methylation status and epigenetic functioning – an important element in cancer prevention.
  • Sea vegetables, sea salt, and seafoods. These are good sources of trace minerals such as iodine, which is a critical anti-cancer nutrient.

In general cancer patients should focus on the foods in the apple of the PHD Food Plate more than the “pleasure foods.” However, there’s nothing wrong with some berries, dark chocolate, pistachios, and whipped cream for dessert, and some red wine with dinner. Above all, it’s important to enjoy your food. Try to obtain from every meal a sense of pleasure and well being!

Supplements

Much more could be said on this topic than I’m going to say today. One could make a very long list of supplements that might help against cancer (also a long list of those that hurt). However, the crucial five from my point of view are in our recommended supplement list:

  • Vitamin D
  • Vitamin K2
  • Iodine
  • Selenium
  • Magnesium

The tricky one here is the iodine. Iodine dosage should be built up very slowly from a low level, so as not to disrupt thyroid function. (Hyperthyroidism can strongly promote cancer, and hypothyroidism can inhibit immune function and healing, so any thyroid dysfunction is a serious risk.) Start at 500 mcg or less, and increase the dose no faster than a doubling per month. If you get either hypothyroid or hyperthyroid symptoms from an increase in dose, back off a bit (eg instead of going directly from 500 mcg to 1 mg per day, go to 500 mcg and 1 mg on alternate days). Be patient, but try to build up to 12 mg/day over a 6 month period. Then stay there. Be sure to get 200 mcg/day selenium along with the iodine.

I also recommend a multivitamin, for general nourishment; and make sure there is no deficiency of vitamin C, zinc, copper, or chromium. Also, when it comes to antioxidants, more is not better. Avoid most antioxidant supplements other than glutathione, vitamin C, selenium, zinc, copper, and manganese.

For magnesium, I recommend taking a 200 mg oral supplement of magnesium citrate or a magnesium chelate. Epsom salt baths might not provide magnesium, but they can be a useful source of sulfur (in the form of sulfate) which assists collagen formation.

Vitamin C is an unusual case. It supports collagen formation, and for this purpose and to avoid a deficiency I strongly suggest taking 1 g per day. In higher doses, vitamin C may be helpful because it has anti-viral properties (see Fighting Viral Infections by Vitamin C at Bowel Tolerance, Sep 26, 2010), and most cancers are probably viral in origin. Linus Pauling, of course, advocated high doses of vitamin C – either taken orally to bowel tolerance, or intravenously. However, there are arguments on the other side. Vitamin C can protect cancer cells from immune attack, and also makes them resistant to chemotherapies. Clinical trials have not yet proven high-dose vitamin C therapy, but it may help against a subset of cancers caused by viruses sensitive to vitamin C therapy.

If sufficient amounts are not obtained from diet, then choline should be supplemented.

Intermittent Fasting, Intermittent Ketosis, Intermittent Protein Restriction

This is an extremely important cluster of strategies that are probably highly effective against cancer.

Their common trait is that all three promote autophagy, or “self-eating,” which is both a means for cells to cope with resource scarcity and a central part of the intracellular immune response.

When resources are abundant, cells allow aged organelles and junk proteins to accumulate. When resources are scarce, they turn on autophagy and digest unnecessary components, recycling the resources.

Autophagy is the dominant innate immune mechanism inside cells – the primary way cells kill bacteria and viruses.

Autophagy also recycles damaged mitochondria, which can be digested, enabling remaining healthy mitochondria to multiply. The result is a healthier mitochondrial population.

Since viruses and damaged mitochondria promote cancer, autophagy helps transform cells from the cancer phenotype back to the normal human phenotype.

Fasting, by inducing resource scarcity, promotes autophagy. Scarcity of amino acids, which can be achieved by a protein restricted diet, also promotes autophagy. And ketosis, which is part of the metabolic profile of starvation, also promotes autophagy.

Note in my section heading the shared word: “intermittent.” We don’t want to sustain fasts or protein scarcity too long; that could create malnourishment and cause more harm than good. Permanent ketosis may promote fungal infections. The most helpful course is probably to follow these strategies intermittently:

  • Engage in daily intermittent fasting: eat only within a 6 to 8 hour window each day. Within the fasting period, eat some coconut oil or MCT oil to promote ketosis.
  • Eat high protein for a few weeks while engaging in resistance exercise to build muscle; then low protein for a few weeks.

A Note on Ketogenic Diets

Since we wrote our book, we’ve become a bit less excited about the therapeutic potential of ketogenic diets.

Ketogenic diets have demonstrated effectiveness in brain cancers, and several considerations suggest that they would be helpful against all cancers:

  • Cancer cells are dependent on glucose metabolism, a phenomenon called the Warburg effect. In ketosis, blood glucose levels can be decreased – a fall from 90 to 65 mg/dl is achievable – and reduced glucose availability should retard cancer growth.
  • Mitochondria do well on ketones, and some studies had shown that provision of ketones can restore the ability of mitochondria to trigger apoptosis, or the programmed cell death of cancer cells.

It’s too early to judge, but a few scraps of data published recently have made ketogenic diets seem a bit less exciting then hoped.

First, the group of Michael Lisanti has published work suggesting that tumors can evade the metabolic restrictions of a ketogenic diet by manipulating neighboring normal cells. The idea (here is an overview) is that cancer cells release hydrogen peroxide, which causes a stress response in neighboring cells, stimulating them to release lactic acid, which the cancer cells can metabolize. This process can happen nearly as well on a ketogenic as on a normal diet, so the effectiveness of a ketogenic diet in starving the cancer cells is reduced.

The Lisanti group results are hardly conclusive – indeed so far as I know no other group has supported their claims – and there are plenty of skeptics. Jimmy Moore gathered responses from a panel of low-carb experts.

Second, clinical experience with ketogenic diets has not yet shown them to be highly effective. The sort of data we have is well represented by a recent report in Nutrition and Metabolism. Sixteen patients with advanced metastatic cancer were put on ketogenic diets. The results:

One patient did not tolerate the diet and dropped out within 3 days. Among those who tolerated the diet, two patients died early, one stopped after 2 weeks due to personal reasons, one felt unable to stick to the diet after 4 weeks, one stopped after 6 and two stopped after 7 and 8 weeks due to progress of the disease, one had to discontinue after 6 weeks to resume chemotherapy and five completed the 3 month intervention period.

The conclusion: a ketogenic diet “has no severe side effects and might improve aspects of quality of life and blood parameters in some patients.”

Clinical trials with control groups and more statistical power are needed to evaluate whether ketogenic diets have therapeutic effect. For now, I think the most prudent course is intermittent ketosis and intermittent ketogenic fasting, rather than a continuously ketogenic diet.

UPDATE: Mario makes a great point in the comments: fasting prior to chemotherapy reduces toxicity to normal cells but increases toxicity to cancer cells. It is quite likely that a ketogenic diet might have the same effect during chemotherapy. So the combination of intermittent ketogenic dieting with chemotherapy should be given consideration.

Circadian Rhythm Enhancement

Many diseases become more likely, or more severe, if circadian rhythms are disrupted. Enhancement of circadian rhythms may be therapeutic for these diseases.

I’ve blogged about circadian rhythm therapies for hypothyroidism (“Intermittent Fasting as a Therapy for Hypothyroidism,” Dec 1, 2010) and for sleep disorders, psychiatric disorders, neurodegenerative disorders, and obesity (“Seth Roberts and Circadian Therapy,” Mar 22, 2011).

Well, cancer is another disease for which circadian disruption may be damaging. The International Agency on Research on Cancer (IARC) has recently classified “shiftwork that involves circadian disruption” as “probably carcinogenic to humans.”

It’s plausible that circadian enhancement may be therapeutic for cancer. Tactics that enhance circadian rhythms include:

  • Exposure to mid-day sunlight.
  • Sleeping in total darkness during hours of darkness.
  • Confining eating to daylight hours.
  • Socializing – especially, looking at faces and talking – during daylight hours. Seth Roberts found that looking at images of human faces can substitute for actual socializing.
  • Exercising during daylight hours. Even low-level activity – like standing instead of sitting – helps.
  • In people who are melatonin deficient due to a brain immune response, supplementation of melatonin just before bedtime.

Curiously, circadian rhythm disruption seems to make chemotherapy more effective. Also, timing treatments to match circadian rhythms may double their effectiveness.

Exercise and Other Lifestyle Factors

A number of lifestyle factors are important for cancer recovery. David Servan-Schreiber’s Anti-Cancer has an excellent overview of the evidence.

A recent study in the Lancet found that every additional 15 min of daily exercise beyond 15 min a day reduced all-cancer mortality by 1%. Exercise appears to be therapeutic even for late stage cancers. A meta-review found that two and a half hours of exercise a week could lower a breast cancer patient’s risk of dying or cancer recurrence by 40 percent, and could reduce a prostate cancer patient’s risk of dying from the disease by about 30 percent.

However, exercise should not be exhausting. Rather, it should be restful and relaxing; or build muscle. Resistance exercise on the “Body by Science” model of one intense workout per week, with more time spent in restful recovery than in stress, is probably a good strategy. Long walks outdoors in nature, and relaxing exercises like yoga or tai chi, are also great approaches to cancer therapy.

Being sociable, happy, calm, and optimistic are all important factors for cancer recovery. Those who have companions they love, and a purpose for living that makes them happy, have the best prognosis. Be grateful for what you have, and make your body understand that life is worth living.

Dealing with Anorexia and Nausea

Anorexia and nausea can seriously impair the ability of cancer patients to eat a nourishing diet and maintain their strength.

I haven’t had time to research this aspect of the disease yet, but there do seem to be some dietary and lifestyle interventions that help.

For instance, exercise can correct anorexia.

Among dietary interventions, ginger has been reported to reduce chemotherapy-induced nausea, reducing incidence in one study from 93% to 55%. (Hat tip: Healthy Fellow.)

Ginger teas are a traditional Asian folk remedy. Slice some ginger root in water, boil it on the stove, add some rice syrup for sweetness, and drink up!

Under-Utilized Therapies

There are a few therapies which are rarely prescribed, but might be more helpful than chemotherapies in treating cancer:

  • Low-dose naltrexone.
  • Anti-viral drugs.
  • Anti-fungal therapies.

Low-dose naltrexone is taken at night before bed. It temporarily blocks opioid receptors, which leads the body to increase production of endorphins and enkephalins – immune compounds which interact with opioid receptors. The following day, the naltrexone is gone and the opioid receptors are working again, but the endorphins are still around. Taking LDN thus increases endorphin levels. Endorphins inhibit cancer proliferation, and may enhance anti-cancer immunity. Here is a recent paper on anti-proliferative effects of LDN against ovarian cancer: http://pmid.us/21685240. Here is a recent paper on LDN plus alpha lipoic acid as a therapy against pancreatic cancer: http://pmid.us/20042414. For a general overview, see http://lowdosenaltrexone.org/.

Viruses cause or contribute to most cancers, and thus anti-viral drugs have great potential. A few cancer-causing viruses are famous, such as the Human Papilloma Virus for which there is a vaccine; however, most of the viruses that cause cancer remain unknown, though we know they exist because genetic mutations that impair viral immunity greatly increase cancer incidence.

Mario Renato Iwakura recently sent me a link to a paper that nicely illustrates the potential of antiviral therapies against cancer. Cytomegalovirus, also known as human herpes virus 5, is a common virus that infects 40% of adults worldwide and 50% to 80% of Americans. However, it is found in almost 100% of human tumors. It seems to be difficult to get cancer if you haven’t been infected by cytomegalovirus.

From the paper abstract:

Medulloblastomas are the most common malignant brain tumors in children…. Human cytomegalovirus (HCMV) is prevalent in the human population and encodes proteins that provide immune evasion strategies and promote oncogenic transformation and oncomodulation…. Remarkably, all of the human medulloblastoma cell lines that we analyzed contained HCMV DNA and RNA and expressed HCMV proteins at various levels in vitro. When engrafted into immunocompromised mice, human medulloblastoma cells induced expression of HCMV proteins. HCMV and COX-2 expression correlated in primary tumors, cell lines, and medulloblastoma xenografts. The antiviral drug valganciclovir and the specific COX-2 inhibitor celecoxib prevented HCMV replication in vitro and inhibited PGE2 production and reduced medulloblastoma tumor cell growth both in vitro and in vivo.

Tumor growth declined by 72% when treated with Valcyte (valganciclovir) and an NSAID drug. A press release notes that these drugs have “relatively good adverse effect profiles” and that “antiviral drugs are selective and largely affect infected cells.”

Yet another antimicrobial approach that may be helpful against cancer is antifungal therapy. Most cancer patients develop systemic fungal infections, and fungal infections such as Candida promote metastasis and tumor growth, and may also suppress anti-cancer immunity. An effective antifungal therapy may significantly retard cancer progression.

Conclusion

Much more remains to be said, and it’s certain that we’ll refine these suggestions after more thoroughly studying the literature. But I think this basic approach to an anti-cancer diet can’t be too far wrong.

Our prayers and best wishes go out to all those who are battling cancer.

Omega-3 Fats, Angiogenesis, and Cancer: Part I

In the book we discuss the issue of omega-3 toxicity (pp 56-58, 71-72), why it is most dangerous when omega-3 fats are combined with alcohol or fructose, and why fish oil capsules are particularly dangerous (see Fish, Not Fish Oil Capsules, June 16, 2010).

We recommend eating about 1 pound per week of omega-3 rich marine fish, like salmon, sardines, or herring, but taking no omega-3 supplements. This amount is sufficient to optimize the tissue omega-6 to omega-3 ratio for cardiovascular health, and is not so great as to raise great risks of toxicity. We also recommend avoiding mixing omega-3 fats with sugar or alcohol – a point I reiterated in last week’s post (How to Raise HDL, April 20, 2011):

Drink alcoholic beverages – but only when consuming meals low in polyunsaturated fats. Drink up when you eat beef, but be cautious when the entrée is salmon.

Some new papers have recently come out on the subject of omega-3 toxicity, and may lead some in the Paleo community, possibly including us, to reconsider our advice about omega-3 fats.

High Omega-3 Intakes in the Paleo Community

Our 1 pound fish per week recommendation works out to about 1.5 g omega-3 fats per day. But some Paleo authorities recommend much higher intakes.

Various emailers and commenters have mentioned Robb Wolf’s recommendations. Beth summarized Robb’s advice:

Robb Wolf promotes a short period of hefty omega 3 supplementation for unhealthy folks — on the order of 1g/10lbs of body weight per day.

Which would work out to 18 g/day for me, about 12-fold more than we recommend. Of course, if this is only for a short period, it may not be a big deal. However, I know from emails that some people take large doses continuously. Here’s one of my emailers:

Supplements are 10g of fishoil – 3.5g of epa/dha …

Bit surprised about [recommendation to reduce] the Fish oil, since i’m on the very low end of what other people are recommending, for fat loss as well, ie. robb wolf, poliquin etc.

The Whole9 folks host a Robb Wolf fish oil calculator which recommends that a 180-pound man take 4.5 g EPA+DHA per day. Depending on whether it is accompanied by other omega-3 fats in fish oil, this could be anywhere from 3 to 10 times our recommended intake, and is in line with what my emailer was taking.

Some Known Consequences of Omega-3 Excess

What are the likely consequences of omega-3 toxicity?

The obvious dangers are those related to oxidative stress from lipid peroxidation. The concern with omega-3 fats is not direct toxicity, but toxicity from their oxidation products. Omega-3 fats have a lot of fragile carbon double bonds which are easily oxidized: EPA has 5 double bonds and DHA 6. These are therefore among the most fragile lipids in the human body.

We would expect such problems to show up primarily in the liver and in the nervous system, where EPA and DHA levels are highest.

Indeed, they do. In mice, high dietary omega-3, in conjunction with alcohol or sugar, induces fatty liver disease. [1] In pregnant rats, excessive doses of omega-3 fats cause offspring to have shortened life span and neural degeneration. The authors concluded, “both over- and under-supplementation with omega-3 FA can harm offspring development.” [2]

However, there are associations of high omega-3 intake with disease in other tissues. In particular, emerging work is linking high omega-3 intake to diseases of pathological angiogenesis.

Angiogenesis is the creation of new blood vessels in mature tissue. (Vasculogenesis is the creation of vessels in a developing embryo.) It is a normal part of wound healing, but over a dozen diseases feature inappropriate angiogenesis.

Omega-3 Intake Is Usually Anti-Angiogenic

Before I go further, let me emphasize that nothing I am saying here repudiates the idea that it is desirable to bring tissue omega-6 and omega-3 fats into proper balance.

There are many studies showing that when tissue omega-6 to omega-3 ratios are too high, as on the standard American diet (SAD), additional omega-3 DHA and EPA can improve the omega-6 to omega-3 balance, reduce inflammatory signaling, and through reduced inflammation exercise an anti-angiogenic effect.

The mechanisms linking the anti-angiogenic effects of omega-3 to a condition of omega-6 excess are fairly well understood. Here is one description of the mechanism:

Here, we demonstrate that omega-6 PUFAs stimulate and omega-3 PUFAs inhibit major proangiogenic processes in human endothelial cells, including the induction of angiopoietin-2 (Ang2) and matrix metalloprotease-9, endothelial invasion, and tube formation, that are usually activated by the major omega-6 PUFA arachidonic acid. The cyclooxygenase (COX)-mediated conversion of PUFAs to prostanoid derivatives participated in modulation of the expression of Ang2. Thus, the omega-6 PUFA-derived prostaglandin E2 augmented, whereas the omega-3 PUFA-derived prostaglandin E3 suppressed the induction of Ang2 by growth factors. Our findings are consistent with the suggestion that PUFAs undergo biotransformation by COX-2 to lipid mediators that modulate tumor angiogenesis, which provides new insight into the beneficial effects of omega-3 PUFAs. [3]

So the question at issue is not whether omega-6 and omega-3 balance needs to be achieved. Rather, two points are at issue:

(a)  At what level of polyunsaturated (and omega-3) fat intake should balance be achieved – high or low?

(b)  Does overshooting toward an omega-3 excess generate significant or insignificant dangers?

If omega-3 toxicity is significant, then it will be important to achieve balance at low intakes of both omega-6 and omega-3, and to be careful to avoid overshooting to an omega-3 excess.

New Paper: DHA Linked to Cancer Progression

A new paper, just published yesterday, from “the largest study ever to examine the association of dietary fats and prostate cancer risk” has linked blood DHA levels to cancer risk. Specifically:

Docosahexaenoic acid was positively associated with high-grade disease (quartile 4 vs. 1: odds ratio (OR) = 2.50, 95% confidence interval (CI): 1.34, 4.65) … [4]

This is a large effect: the highest quartile had 2.5-fold higher risk than the lowest-quartile.

That it was the omega-3 DHA specifically, and not polyunsaturated fats generally, that caused the problem, is supported by the fact that (note: edited to correct error in original post – PJ) omega-6 linoleic acid had no effect, and 18:1 and 18:2 trans-fats which are mostly obtained from partially hydrogenated vegetable oils were associated with protection against cancer:

TFA 18:1 and TFA 18:2 were linearly and inversely associated with risk of high-grade prostate cancer (quartile 4 vs. 1: TFA 18:1, OR = 0.55, 95% CI: 0.30, 0.98; TFA 18:2, OR = 0.48, 95% CI: 0.27, 0.84). [4]

People in the top trans-fat quartile had only half the risk of people in the lowest omega-6 quartile. This makes it looks like omega-6-derived trans-fats were protective.

This result conflicts with the idea that the only influence of omega-3 fats is through regulation of inflammation; if so the anti-inflammatory omega-3 would have suppressed cancer. As lead study author Theodore Brasky said in the press release:

“We were stunned to see these results and we spent a lot of time making sure the analyses were correct,” said Brasky, a postdoctoral research fellow in the Hutchinson Center’s Cancer Prevention Program. “Our findings turn what we know — or rather what we think we know — about diet, inflammation and the development of prostate cancer on its head and shine a light on the complexity of studying the association between nutrition and the risk of various chronic diseases.”

Angiogenesis A Possible Pathway

Angiogenesis is very important for cancer progression. Cancers need to form angiogenic vessels if the tumor is to be able to grow beyond about 0.5 mm (0.02 inch) in diameter.

Indeed, angiogenesis seems to be a controlling factor for cancer mortality risk. It is believed that 50% of adults over age 40, and 100% of adults over age 70, have microscopic cancers. However, most tumors never develop an ability to induce angiogenesis and thus the tumors never grow beyond 0.5 mm and cause no observable disease.

Dietary factors that promote angiogenesis favor cancer progression, and anti-angiogenic factors tend to prevent cancer progression. Diet seems to be crucial for cancer prevention. Here is a TED video by Dr. William Li discussing the link between angiogenesis, dietary influences upon angiogenesis, and cancer.

Conclusion

So far, we’ve set the stage. On Thursday I’ll discuss a mechanism by which excessive DHA intake may promote angiogenesis. If this mechanism is important, then excessive fish oil or DHA supplementation may act as a major cancer-promoting food.

UPDATE: The next post in this series: Omega-3s, Angiogenesis and Cancer: Part II

References

[1] Nanji AA et al. Dietary saturated fatty acids: a novel treatment for alcoholic liver disease. Gastroenterology. 1995 Aug;109(2):547-54. http://pmid.us/7615205.

[2] Church MW et al. Excess omega-3 fatty acid consumption by mothers during pregnancy and lactation caused shorter life span and abnormal ABRs in old adult offspring. Neurotoxicol Teratol. 2010 March – April;32(2):171-181. http://pmid.us/19818397.

[3] Szymczak M et al. Modulation of angiogenesis by omega-3 polyunsaturated fatty acids is mediated by cyclooxygenases. Blood. 2008 Apr 1;111(7):3514-21. http://pmid.us/18216296.

[4] Brasky TM et al. Serum Phospholipid Fatty Acids and Prostate Cancer Risk: Results From the Prostate Cancer Prevention Trial. Am. J. Epidemiol. April 24, 2011 DOI: 10.1093/aje/kwr027 (Will be at http://pmid.us/21518693.)

Around the Web; Happy Valentine’s Day!

Happy Valentine’s Day, everyone!

[1] Paleo Summit: Sean Croxton is about to launch his “Paleo Summit”. It features multimedia interviews with 23 speakers, including myself. It’s a mini-Ancestral Health Symposium, but without the travel. Check it out!

[2] Dan’s Plan: I’ve agreed to become a scientific advisor to Dan’s Plan.

Dan’s Plan is a promising young startup founded by Dan Pardi, one of the rising stars of the ancestral health community. Dan’s Plan is pioneering “Quantified Paleo,” the use of Quantified Self tools to help members adopt an ancestral lifestyle and to support self-experimentation and group experimentation that can solve health problems.

Dan’s Plan provides content modules in three areas: Eat, Sleep, Move. “Eat” is about diet, of course; “Move” about fitness; and “Sleep” about lifestyle generally – how do you support healthy circadian rhythms?  We’ll be contributing Perfect Health Diet-based content, such as meal plans, to the “Eat” section.

One of the things that has me excited about Dan’s Plan is the potential for us to do science together as a community. Quantified Self tools make it easy to record data and upload them to a database. Suppose Dan’s Plan ends up with content modules for a half dozen different diets. The Dan’s Plan database may be able to track results for every diet, charting out weight loss results, quit rates, and other data for the community. Is it normal to gain a few pounds at the start of the diet? All kinds of questions can be answered with this kind of data, and we can more effectively find out what really works.

I’ll have more to say about Dan’s Plan and what we’ll be doing with them later. For now, I’d just like to encourage anyone who’s curious to become a member. Membership in Dan’s Plan is free.

[3] Other news: I had a very fun interview last week with Andy Oudman and Pam Killeen of 1290 AM CJBK, London, Ontario. Pam is associated with the Weston A Price Foundation and will be speaking at this year’s Wise Traditions conference; Andy is the most popular radio host in London and extremely entertaining. Thanks, Pam and Andy!

Also, Constantin Gonzalez has published a German language review of our book. (English-language translation)  Constantin also produced a German-language version of our food plate. Thanks Constantin!

[4] Music to Read By: These are the Valentine’s dreams you will savor:

[5] Cute Animals:

Via Jasmyn Campbell.

[6] Interesting recent items:

Steph is ready for a bright, shining world.

The Atlantic has a great story on a topic we’ve discussed previously: Toxoplasma gondii infections alter behavior. One claim: Toxo may kill as many people as malaria, a million people per year, when you account for its induction of reckless behavior.

Via John Hawks, malaria kills twice as many people as previously thought. They were only counting deaths from acute infection, but chronic infection kills too.

But it’s not all bad news: T. gondii makes you have car accidents, but soil bacteria puts you in a good mood.

Did biological warfare win the Stalingrad campaign?

Mark Sisson discusses the “Asian Paradox”: how can Asians eat rice in the “insidious weight gain” calorie region, and not gain weight?

Ann Marie Michaels, aka Cheeseslave, explains why she ditched low carb. Barry Cripps of Paleo Diet News also benefited from increasing carbs. Julianne Taylor disputes the “carbs can kill” meme.

Matt Metzgar reviews our book; he wants us to go higher carb. Joanne Eglash gives us a mention in examiner.com.

Speaking of reviews, I reviewed Richard Nikoley’s new book on Amazon. I think it’s an excellent introduction to “Paleo 1.0”.

New research may explain why the zebra got its stripes. Revisions may be necessary to this book.

Monsanto is coming out with genetically engineered omega-3 producing soybeans.

FoodSnipps has recipes for Perfect Health Dieters. Mike Skiff is starting a 30-day experiment. JD Moyer discusses the benefits of intermittent fasting, with a link to us.

Dennis Mangan wonders: What’s behind the obesity epidemic in pets?

Bruce Charlton argues for electroconvulsive therapy, nicotine patches, and caffeine against Parkinson’s.

Congratulations, Razib!

The Flavorists have triumphed: the many flavors of Chinese potato chip.

Mayonnaise is even more dangerous than I thought. (Via Rantburg.)

Stephan Guyenet wonders if smoking delayed the obesity epidemic by keeping people in the 1950s and 1960s lean. I wonder if smoking epigenetically modified the children, promoting obesity in the next generation.

J Stanton sends me a link: pork is good for – stanching nosebleeds?

Visiting social web sites relaxes the heart.

Dr Briffa shares a picture of a man who injected insulin in his belly repeatedly.

Finally, Chicago magazine has an article on Dr Mercola. I thought his history was interesting:

At first, he was a traditional drug-prescribing doctor…. “I thought drugs were the answer,” he says with a shrug.

That changed in the early 1990s, when conventional treatments failed to help a young patient with recalcitrant diarrhea. Flummoxed, Mercola found a possible answer in a book called The Yeast Connection. After he tried the all-natural protocol the book recommended, he says, “the kid had a miraculous recovery.”

Over the next several years, Mercola began networking with a number of like-minded physicians “who were getting pretty good results with nontraditional therapies.” He grew increasingly skeptical of traditional medicine and interested in treatments designed, he says, to “treat the whole person” rather than just symptoms….

In 1997, as a way to share what he had found that would be “useful and helpful,” he started Mercola.com. It proved a hit.

[7] Bonus animal: We all need a hug now and then:


Via Godvine.com.

[8] Comments:

Sofie recommends fasting for avoidance of jet lag.

Connie Warner tells about an unexpected food contaminant: “I remember hearing from an FDA food safety chemist that he wouldn’t eat shrimp because the rat urine from the ship rats wouldn’t wash out of the shrimp.”

Josh Almanza on Facebook presents evidence white rice is better than brown rice.

[9] Honorable mention: An article about us appeared in the February edition of Healthy Cells magazine: “What’s For Dinner?” by Sandra Bender, BSN, PhD, on pp 8-9:

My husband and I chose the Perfect Health Diet after cancer treatment because we feel healthier than on the plant-based diet, we enjoy the food – and my long-lived grandparents ate this. Daily, we eat about four ounces meat, four ounces fish, ¾ cup cooked rice or potatoes, eggs, cheese, and whole fermented milk (kefir), lots of vegetables, and fruit for dessert, all organic. We eat fat with meat and dairy, butter, gravy, or coconut sauces on everything. Once a day we have a half-ounce dark chocolate, an anti-cancer antioxidant. Yummy! After eating this way for two years, my cholesterol and triglycerides are excellent and inflammation markers and insulin are low. My omega 3:6 is balanced.

[10] Not the Weekly Video: Max Ehrmann’s “Desiderata”:

Desiderata from R Smittenaar on Vimeo.

[11] Shou-Ching’s Photo Art:

[12] Weekly video: Dr Thomas Tartaron lectures on Ötzi the Iceman. Interesting aspects: Ötzi had Lyme disease and intestinal whipworm parasites; he had atherosclerosis and calcified coronary arteries despite a “healthy” (but grain-rich) diet and plenty of exercise.

Via Dienikes.