Target: Cancer

Recent research studies are pointing to some familiar
natural methods to help reduce risk.

By Eric Schneider

May 2009

The ever-shifting terrain of cancer research is dotted with new paths to follow and technologies to explore. Some of these discoveries offer one of the most important weapons in this ongoing battle—hope. Energy Times talked to a number of leading cancer experts to find out about some of the latest developments in their respective fields, and what tried-and-true methods are still most effective in reducing risk and detecting and treating cancer.

Reducing Your Risk

First, the basics. One way to take control of a disease that often seems insurmountable is to take preventative measures and embrace a healthful lifestyle. Avoiding alcoholic beverages, being physically active and maintaining a healthy weight will have a “modest” protective impact against breast cancer, says Debbie Saslow, PhD, director of Breast and Gynecologic Cancers for the American Cancer Society in Atlanta, Georgia. The soundness of this advice been reinforced in a recent study by the University of South Carolina, which discovered that women who engage in regular aerobic exercise are three times less likely to die of breast cancer than those who are generally inactive (Medicine & Science in Sports & Exercise 4/09).

Meanwhile, an increasingly popular beverage—green tea—may have a protective effect against breast cancer. According to a study published in the February 2009 Journal of Nutrition, researchers found a slight reduction in the risk of this disease among regular green tea drinkers. Vitamin D may also help protect against breast cancer. German scientists have found high bloodstream levels
of D to be associated with reduced breast cancer risk in premenopausal women (International Journal of Cancer 1/1/09).

New data has confirmed the effect of oral contraceptives for reducing the risk of ovarian cancer. A key reanalysis of 45 epidemiological studies concluded that oral contraceptives have prevented around 200,000 cases of ovarian cancer and 100,000 deaths directly related to the disease (Lancet 1/26/08). On the natural front, the herb ginkgo biloba may reduce the risk of ovarian cancer (Cancer Letters 6/18/07). “Tubal ligation and maintaining a healthy weight are also protective,” says Saslow.

And, as with women who are at high risk of breast cancer, particularly those who have inherited a gene mutation in one of the BRCA "breast cancer" genes, women at high risk of ovarian cancer have considered prophylactic surgery, which involves the removal of healthy breasts or ovaries.

Across the gender aisle, there is less certainty concerning the prevention of prostate cancer. Dr. Durado Brooks, MD, MPH, director of Prostate and Colorectal Cancers for the American Cancer Society, acknowledges that in his field, “not a lot is known” about reducing risk. “The only risk factors,” Brooks says, “are things that men can’t modify—age (the primary risk factor), family history and being African-American, particularly of West African descent.”

On the upside, however, is a study published in the March 24, 2009 edition of Clinical Cancer Research, which found that omega-3 fatty acids (common in salmon and other fatty fish, as well as flax) may reduce the risk of developing advanced prostate cancer. European researchers have found that saw palmetto has induced apoptosis, a form of natural cell death, in prostate cancer cells (BJU Interna­tional 1/12/09). Lycopene, a substance that gives tomatoes their rich red color, has also been linked to a reduction in prostate cancer risk: In one study lycopene supplementation significantly lengthened the time it took PSA levels to increase (Journal of Urology 12/08).

In the case of colorectal cancer, Brooks says, the most powerful prevention is getting screened for the disease. “The tests that we use to help try to find the disease early also help us find precursors to cancer—what are called ‘polyps,’” he says. “It is strongly believed that the increased use of colonoscopy in polyp removal over the last couple of decades has had a significant impact on colorectal cancer rates. We’ve seen a steady fall in rates over the last 15 to 20 years, and much of that is likely due to screening.”

Physical activity also helps, Brooks adds. “Exercise has been shown to decrease the risk of colorectal cancer,” he says. Other preventive steps include limiting meat and fat intake, cutting out tobacco, and avoiding excessive alcohol use. Recent studies have also shown that maslinic acid, a compound found in olive skins, may provide a protective effect against colorectal cancer.

Women with a higher intake of calcium appear to have a lower risk of cancer overall, and both men and women with high calcium intakes have lower risks of colorectal cancer and other cancers of the digestive system, according to a report in Archives of Internal Medicine (2/23/09). The Institute of Medicine recommends 1,200 milligrams of calcium for adults age 50 and older.

Moving up to the respiratory system, it will come as no surprise that most lung cancer cases—about 89% in men, 72% in women—are caused by smoking. Michael J. Thun, MD, MS, vice president emeritus of Epidemiology and Surveillance Research at the American Cancer Society, points out that decreased smoking among men, especially those with more than a high school education, have reduced the male death rate from lung cancer by 23% from 1990 to 2005; the death rate in women has stopped increasing and leveled off.

Of course, lung cancer isn’t limited to smokers. “If lung cancer caused by factors other than smoking was considered a separate disease,” Thun says, “it still would rank among the 10 most common cancers in the US.” Lung cancer risk can be reduced by avoiding secondhand smoke, radon gas, asbestos and other industrial pollutants (including arsenic, chromium and cadmium) and small-particulate pollution, especially from coal.

A study in the Journal of the American Medical Association (9/28/05) discovered that an estrogen-like compound called phytoestrogens, found in vegetables, grains, and legumes, may protect against lung cancer in both smokers and non-smokers.

Just as not smoking is a commonsense approach to lung cancer prevention, a comprehensive

program of sun protection is still the foundation of skin cancer prevention, according to David J. Leffell, MD, David Paige Smith Professor of Derma­tology and Surgery at the Yale School
of Medicine and author of Total Skin: The Definitive Guide to Whole Skin Care for Life (Hyperion).
In recent years, some elementary schools have been proactive in implementing sun protection programs, which studies have shown can decrease the risk of developing skin cancer. Among recommended steps in the US Environmental Protection Agency’s SunWise program: generously apply sunscreen, wear protective clothing and seek shade. The program also discourages using tanning salons, which have recently tried to lure customers with claims of getting essential vitamin D via the UV rays of tanning beds.

The safe, recommended method of getting vitamin D remains through the diet, either from salmon and other fatty fish, eggs, and other D-rich foods or from vitamin supplements and fortified foods such as milk, cereal, and bread. The American Academy of Dermatology (AAD) underscores obtaining adequate vitamin D without UV overexposure from sunlight or tanning beds. “Vitamin D is essential for optimal health, and the medical literature supports safe ways to get it—a diet with foods naturally rich in vitamin D, vitamin D-fortified foods and beverages, and vitamin D supplements,” says dermatologist C William Hanke, MD, AAD’s president.

Detecting Cancer

For detecting skin cancer, Leffell says, “The best computer is still between the two ears of the dermatologist. Most of the ‘scanning’ devices are basically digital photography that use algorithms to determine if a mole is abnormal. But no software is more accurate than a well-trained dermatologist.”

Leffell says that advancements in detection are on the way, saying he expects improvements in technologies such as confocal microscopy “that will allow us to look at moles and suspicious lesions at the microscopic level in vivo, and avoid the need for biopsy in many cases.”

As with skin cancer, breast cancer detection is a familiar routine. Says Saslow, “The ‘gold standard’ is still annual mammograms—emphasis on annual—starting at age 40.” A new variation on this is the ACS’s guideline for women at high risk, which recommends MRI (magnetic resonance imaging) in addition to mammograms for high-risk women. Saslow says that digital mammograms show a slight advantage over film mammography for younger/premenopausal women and women with “mammographically dense breasts.” A number of recent studies have found that women with dense breasts have an increased risk of developing the disease.

Still elusive is a viable screening method for ovarian cancer, which is difficult to detect until it has spread. A recent British study, while preliminary, does look promising: It showed that screening is feasible, with firmer results expected in about five years. A number of possible symptoms have been identified: bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and urinary urgency or frequency. But Saslow expresses caution. “These symptoms are very common and rarely will mean the woman has ovarian cancer,” she says. “But women who have these symptoms almost every day for more than a month should ask their doctor to consider an evaluation for ovarian cancer.”

The hurdles associated with screening for and detecting prostate cancer, Brooks says, are related to a large degree to the fact that “prostate cancer is primarily a disease of older men, and the longer you live, the more likely you are to develop the disease, and many prostate cancers are very slow growing. It’s often said that many more men die with prostate cancer rather than of prostate cancer.

Consequently, men may actually development a cancer that causes them no significant harm during the course of their life.” As a result, one increasingly common perspective is the “wait and see” approach, which may spare men the difficulties of unnecessary treatment. As Brooks says, “prostate cancer treatments are far from benign.”

Though recent studies on prostate cancer screenings have had mixed results, Brooks points to genetic markers, which he says offer “hope that we may find certain gene patterns that are associated with prostate cancer aggressiveness. That’s an area where lots of research is going on.”

The primary approach to prostate cancer screening is the somewhat controversial prostate specific antigen (PSA) blood test. The test looks for a protein that, Brooks says, “is normally found in very small amounts in the blood, but, in the case of prostate cancer, is found in much greater amounts—sometimes.” Most authorities recommend that the PSA test be administered in association with the digital rectal exam (DRE). As Brooks explains, “The PSA will find some cancers that the DRE will miss, and the DRE will find some abnormalities that the PSA may not detect. Most organizations, including the American Cancer Society, recommend that men be informed that these tests are available. The tests have some potential benefits, but also some limitations.” Men should decide about screening based on their preferences, he adds.

While the detection of colorectal cancer has generally relied on the colonoscopy, the less invasive sigmoidoscopy and the fecal occult blood test, which checks for blood in the stool, newer technology has updated these procedures, with some now working at the cellular level. “Stool DNA testing actually looks, not for blood, but for mutations of DNA that are associated with polyps and cancers,” Brooks observes.

Even the always anxiety-causing colonoscopy has received an upgrade with the CT (computed tomography) colonoscopy or “virtual colonoscopy.” “It’s a way of examining the inside of the colon and looking for polyps or other abnormalities without actually having to insert the tube,” Brooks explains. Studies have shown that this CT procedure has a high success rate in detecting both large polyps and tumors.

While there have not been any major developments in lung cancer detection, Thun notes that helical CT scans can detect much smaller nodules than conventional x-rays. But it is not yet known whether removal of these nodules improves survival, he adds. “Large clinical trials are underway to answer this question,” Thun says. “At this point, the American Cancer Society does not recommend screening for the early detection of lung cancer.”

Treatment and Beyond

Researchers are making strides in breast cancer treatment. “There have been advances in identifying which women will most benefit from more aggressive treatment—such as tests that predict the risk of recurrence,” Saslow says. A study published in the March 1, 2009 edition of the International Journal of Radiation Oncology, Biology, and Physics and conducted at the University of Texas M.D. Anderson Cancer Center found that breast cancer patients ages 35 and under face a higher risk of their cancer returning, a discovery that should expand breast cancer studies in that age range. In the area of post-treatment care, Saslow notes “some advances in [breast] reconstruction, as well as studies for preserving fertility.”

For prostate cancer, Brooks explains, the old is new again with cryotherapy, a treatment where a tumor is frozen by probes put into the prostate gland. “Early use of cryotherapy 30 years or so ago had a lot of associated complications, but there have been enhancements of the techniques and improvements in the technology,” Brooks says. Other promising developments: HIFU or high intensity focused ultrasound, which destroys the tumor with sound waves, and robotic surgery, a procedure designed to remove fine human tremors, allowing for less blood loss and, consequently, shorter hospital stays.

When treating colorectal cancer, surgery is often the main option. However, many people are wary of surgery, though possibly for the wrong reasons. Brooks says, “One of the myths that I continually work to dispel is that many people believe that if they have colorectal cancer diagnosed, and they have to undergo surgery, that they are going to end up with a lifelong problem. That is, their colon will no longer work, and they’ll have to have a bag attached to the outside of their body. Fortunately, that is a very rare occurrence.”

One treatment area in which advances have been lacking is lung cancer. “Survival for people diagnosed with lung cancer (all types and stages combined) is poor, and hasn’t improved much over the last 30 years,” Thun says, adding that the five-year relative survival rate was 12.7% in the mid-1970s and is now 15.7%. “However, there are some encouraging findings,” Thun adds. “Almost half of patients who are diagnosed when their cancer is still localized survive for at least five years.”

For those who favor natural solutions, some strides are being made in treating skin cancer, where, Leffell says, “the trend is toward non-surgical treatment. The hot topic now is photodynamic therapy, where a solution or cream is applied to the skin. It is then activated by light and the free radicals that are generated are thought to kill cancerous and precancerous cells. We use these techniques extensively. ”

Scientists are also looking at natural substances that boost immunity. For example, arabinogalactan, a type of fiber found in the larch tree, has shown an ability to reduce cancer spread, or metastasis, to the liver in laboratory animals.

Skin cancer treatment may be a moot point if people take steps to reduce their risk in the first place. Says Leffell, “No matter how many articles are written, people still resist following a good sun protection program, and still often put off getting worrisome moles checked out. I say people who die from melanoma actually die from denial. My rule: When in doubt, check it out. People often have a sixth sense that something is not right.”

Each of us has our own unique set of cancer risk factors. The best way to formulate a cancer prevention program that best suits your needs is to consult a qualified healthcare professional.

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