Lifestyle and Cancer by sammyc2007

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									Lifestyle and Cancer:
Lifestyle and Cancer:

      Chris Lewis, M.D.
   Lela Lewis, M.D., M.P.H.
Lifestyle and Cancer:
  What can be done?
      Chris Lewis, M.D.
   Lela Lewis, M.D., M.P.H.
NOTE:

 CAUTION: These talks are for your
  information only and do not serve to
  create a doctor-patient relationship, if you
  are ill or on medication and wish to
  significantly change your lifestyle you
  should do so under the direction of your
  regular physician.
OUTLINE

1. Briefly review pathogenetic factors in
   oncogenesis.
2. Describe the influence of lifestyle on
   cancer incidence.
3. Explore lifestyle's impact on cancer
   survival.
Statistics
  As of January 2005, cancer deaths
   outnumbered deaths from heart disease
       In individuals less than 85yo
  476,009 cancer deaths
  450,637 deaths from heart disease


    American Cancer Society. Cancer Statistics 2005. Available at:
     http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.a
     sp?sitearea=MED. Accessed January 2005.
Statistics

  Estimated 1,372,910 new diagnoses of
   cancer last year, and 570,260 deaths
   from cancer.




    American Cancer Society. Cancer Statistics 2005. Available at:
     http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.a
     sp?sitearea=MED. Accessed January 2005.
Cancer Deaths

     Women                 Men

                Lung

      Breast        Colon and Rectum

 Colon and Rectum         Prostate

               Pancreas
2006 Estimated US Cancer Deaths*
                             Men            Women
Lung & bronchus   31%                                      26% Lung & bronchus
                            291,270         273,560
Colon & rectum    10%                                      15% Breast
Prostate           9%                                      10% Colon & rectum
Pancreas           6%                                       6% Pancreas
Leukemia           4%                                       6% Ovary
Liver & intrahepatic 4%                                     4% Leukemia
   bile duct
                                                            3% Non-Hodgkin
Esophagus          4%                                             lymphoma
Non-Hodgkin         3%                                      3% Uterine corpus
  lymphoma
                                                            2% Multiple myeloma
Urinary bladder    3%
                                                            2% Brain/ONS
Kidney             3%
                                                           23%   All other sites
All other sites    23%

                  ONS=Other nervous system.
                  Source: American Cancer Society, 2006.
     Common Cancers
Lung cancer #1 killer:
 163,500 estimated deaths for 2005.

Prostate Cancer most common cancer in men:
 >232,000 men are expected to be diagnosed
  with prostate cancer

Breast cancer most common cancer in women:
 >211,000 women are expected to be
  diagnosed with breast cancer this year.
American Cancer Society. Cancer Statistics 2005. Available at:
   http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.asp?siteare
   a=MED. Accessed January 2005.
Cancer Trends
 Prostate and female breast cancer rates have
  continued to rise.

 Lung cancer incidence in men continues to
  decrease in men.

 In women, lung cancer rates have been
  increasing for past years but are finally leveling
  off.


   Jemal A, et al. CA Cancer J Clin 2005;55:10-30. Cancer Statistics.
      Cancer Incidence Rates* for
      Men, 1975-2002
      Rate Per 100,000
250



200                                                   Prostate




150


                                                                 Lung
100

           Colon and rectum
 50                                                    Urinary bladder

       Non-Hodgkin lymphoma
                                                        Melanoma of the skin
  0
  1975        1978       1981       1984       1987       1990          1993    1996       1999       2002


 *Age-adjusted to the 2000 US standard population.
 Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and
  Population Sciences, National Cancer Institute, 2005.
      Cancer Incidence Rates* for
      Women, 1975-2002
      Rate Per 100,000
250



200



150                                                                   Breast



100

           Colon and rectum                                                                    Lung
 50
                                                            Uterine Corpus
           Ovary
                                   Non-Hodgkin lymphoma
  0
  1975        1978       1981       1984       1987       1990       1993       1996       1999       2002


 *Age-adjusted to the 2000 US standard population.
 Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and
  Population Sciences, National Cancer Institute, 2005.
Causes

 1/3 of all cancers are related to
  smoking

 1/3 of cancers related to poor diet,
  lack of exercise, and obesity.
 American Cancer Society. Cancer Statistics 2005. Available at:
 http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_
 2005.asp?sitearea=MED. Accessed January 2005.
Where does cancer
come from?
 Physiology:
The Key to be
Disease Free!
                        Inherited Mutations
P53 tumor           Li-Fraumeni Syndrome       cell cycle          brain tumors,
suppressor                                     regulation,         sarcomas,
                                               apoptosis           leukemia, breast
                                                                   cancer
APC                 Familial Adenomatous       signaling through   colon cancer
tumor suppressor    Polyposis                  adhesion
                                               molecules to
                                               nucleus
BRCA1               Familial Breast Cancer     repair of double    breast and ovarian
tumor suppressor                               strand breaks by    cancer
                                               association with
                                               Rad51 protein
MSH2 and MLH1       Hereditary Nonpolyposis    DNA mismatch        colorectal cancer
tumor suppressors   Colorectal Cancer type 1   repair
                    (HNPCC1)
RET proto-          Multiple Endocrine         transmembrane       medullary thyroid
oncogene            Neoplasia Type 2           receptor tyrosine   cancer, type 2A
                                               kinase for glial-   pheochromocytoma
                                               derived             , mucosal hartoma
                                               neurotrophic
                                               factor (GDNF)
Inherited mutations

  The mutation can be passed from
   generation to generation.

  This type of mutation is a major factor for
   only 5% to 10% of cancers.
 Acquired mutations

 90-95% of cancers are caused by
  acquired mutations.
 These types of mutations, unless they
  occur in germ cells, cannot be passed on
  to one‘s children.
The Guard

P53 tumor suppressor gene
 The p53 protein senses DNA damage and can
  halt progression of the cell cycle in G1.

 The p53 protein is also a key player in apoptosis.

   Kimball, JW.
    http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/T/TumorSuppressorGenes.htm
    l#p53 Acquired February, 2005.
    The Guard

 Both copies of the p53 gene must be mutated for
  this to fail so mutations in p53 are recessive.
 Cells which contain only mutant versions of the
  protein can live on — potentially developing into a
  cancer.
 More than half of all human cancers have p53
  mutations and have no functioning p53
  protein.
   Kimball, JW.
    http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/T/TumorSuppressorGenes.html#
    p53 Acquired February, 2005.
   Science 266:1821-1828, Cell Cycle Control and Cancer
DNA Damage

 Mutations occur when genes encoding
  cell cycle controlling proteins are
  damaged.
What Damages DNA?
Inflammation Leads
  to DNA Mutation
 Inflammatory cells produce
  reactive oxygen and nitrogen
  species.

 Oxidative and nitrative DNA
  damage from inflammatory
  processes lead to carcinogenesis.
   Kawanishi S, et al. Biol Chem. 2006 Apr;387(4):365-72. Oxidative
    and nitrative DNA damage in animals and patients with inflammatory
    diseases in relation to inflammation-related carcinogenesis.
   Ness RB, et al. J Natl Cancer Inst. 1999 Sep 1;91(17):1459-67.
    Possible role of ovarian epithelial inflammation in ovarian
    cancer.
                   Colon Cancer and
                     Inflammation
 90% of Colon cancer is due to inflammation
  from:
     Oxidizing free radicals in the diet (e.g. heated
      oil)
     Reactive oxygen and nitrogen molecules
      (Nitric oxide) from immune cells
     Anything which slows passage of digested
      food through the colon (low-fiber diet)
 These cause DNA mutations in genes such as
  p53 and other DNA repair genes resulting
  ultimately in Cancer.

   Itzkowitz SH and Yio X. Am J Physiol Gastrointest Liver Physiol. 2004
    Jul;287(1):G7-17. Inflammation and cancer IV. Colorectal cancer in
    inflammatory bowel disease: the role of inflammation.
     Autoimmune Disease
         and Cancer
 Autoimmune Inflammatory Bowel
  Disease (Crohn‘s and Ulcerative Colitis)
  is accociated with increased rates of
  colon cancer.

   Itzkowitz SH and Yio X. Am J Physiol Gastrointest Liver Physiol. 2004
    Jul;287(1):G7-17. Inflammation and cancer IV. Colorectal cancer in inflammatory
    bowel disease: the role of inflammation.
           Inflammation and
            Gastric Cancer
Stomach inflammation caused by:
 Salted foods (>3 gm Na/day)
 Pickled foods
 Smoked foods
 A high-fat, low-fiber diet
All of these are associated with increased
  incidence of stomach cancer
   Naylor GM, et al. Gut. 2006 Apr 7. Why does Japan have a high incidence of
    gastric cancer? A comparison of gastritis between UK and Japanese
    patients.
   Ernst P. Aliment Pharmacol Ther. 1999 Mar;13 Suppl 1:13-8. Review article: the
    role of inflammation in the pathogenesis of gastric cancer.
    Prostate Inflammation
         and Cancer
 Prostate inflammation/prostatitis is
  now known to be linked to prostate
  tumorigenesis.
   Nelson WG, et al. J Urol. 2004 Nov;172(5 Pt 2):S6-11; discussion S11-2.
    The role of inflammation in the pathogenesis of prostate cancer.
   Sugar LM. Can J Urol. 2006 Feb;13 Suppl. Inflammation and prostate
    cancer.
           Inflammation and
            Ovarian Cancer
 Epidemiologic data relates
  pelvic inflammatory disease
  with ovarian cancer.
   Ness RB, et al. J Natl Cancer Inst. 1999 Sep 1;91(17):1459-67. Possible role of
    ovarian epithelial inflammation in ovarian cancer.

   Ness RB, et al. Epidemiology. 2000 Mar;11(2):111-7.
    Factors related to inflammation of the ovarian epithelium and risk of ovarian
    cancer.
        Metabolic Syndrome and
                Cancer
 Study of 1,800 women
 57% of total calories from
  carbohydrates linked to a 220%
  increased risk of breast cancer
 Link discovered between refined
  carbohydrates and breast cancer
      Secondary to rapid rise in insulin.
 High levels of insulin support
  rapid growth of tumors.

   J of Cancer Epidemiology, 2005
How can we protect
our DNA?
         Antioxidants


 Antioxidants protect DNA by neutralizing
  free radicals.
 Vitamins C, E and beta-carotene are
  antioxidants naturally found in fruits,
  grains, nuts and vegetables.
 The minerals selenium and zinc:
   Improve immune function
   Protect against oxidation and DNA damage
A Last Line of
Defense:
Natural killer and other immune cells
fight cancer by targeting and
destroying cells that have
undergone malignant degeneration.
      What Can We do?



 In addition to early cancer detection and
  prompt treatment, what else can be done
  to help prevent and fight cancer?
   If you are tired of
 worrying about cancer
 You want rest . . .
JESUS says…




 “Come unto to me all ye that labor and are
 heavy laden, and I will give you rest.”
 Matthew 11:28
 Rest to Body, Mind and Soul!
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REMEMBER:
Water
Dehydration and Cancer

 Dehydration increases the risk for cancers of
  the breast, colon, and urinary tract.




 Decrease risk of cancer by drinking 8
  glasses of water each day.
     Kleiner SM. J Am Diet Assoc 1999 Apr; 99(4):411. Water: an essential but overlooked
      nutrient.
     Manz F, and Wentz A Nutr Rev. 2005 Jun;63(6 Pt 2):S2-5. The importance of good
      hydration for the prevention of chronic diseases.
Fresh Air
             Air Pollution and
              Breast Cancer
 Women born in areas of New York with
  high concentrations of air pollution are
  2.4 times as likely to develop breast
  cancer.


 Bonner MR, et al. Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):53-60.
 Breast cancer risk and exposure in early life to polycyclic aromatic hydrocarbons
 using total suspended particulates as a proxy measure.
         Air Pollution and Throat
                  Cancer
 Ozone, a common air
  pollutant, significantly
  increases laryngeal
  cancer.




   Pereira FA, et al. J Air Waste Manag
    Assoc. 2005 Jan;55(1):83-7. Influence of
    air pollution on the incidence of
    respiratory tract neoplasm.
Air Pollution and Cancer

    Diesel exhaust stimulates increased
    concentrations of cytokines.
      Results in inflammation
      Ultimately results in DNA damage and
       lung cancer.

    Mutat Res. 2004 Aug 8;562(1-2):119-31. Inflammatory and genotoxic effects of
    diesel particles in vitro and in vivo.
Fetal Exposure to Diesel
Exhaust Causes Cancer
  Diesel exhaust:
      Crosses the placenta
      Causes DNA deletions in mice fetuses
      Fetal cells divide rapidly
      RESULT: Increases risk of cancer

  TAKE HOME POINT: Diesel exhaust in
  utero puts the fetus at risk.
  Reliene, R, et al. Mutat Res. 2005 Mar 1;570(2):245-52. Diesel exhaust particles
  cause increased levels of DNA deletions after transplacental exposure in mice.
         Radon Deaths in USA




   U.S. Environgmental Protection Agency.
    http://www.epa.gov/iaq/radon/pubs/citguide.html. Obtained 21 March, 2005.
   * Radon is estimated to cause about 21,000 lung cancer deaths per year, according
    to EPA's 2003 Assessment of Risks from Radon in Homes (EPA 402-R-03-003). The
    numbers of deaths from other causes are taken from the Centers for Disease Control
    and Prevention's 1999-2001 National Center for Injury Prevention and Control Report
    and 2002 National Safety Council Reports.
 Fresh Air in Every Room...
      To Avoid Radon
  Studies show that residential radon is the
   second leading cause of lung cancer death.
 Radon enters the home from the ground
   The principal source of exposure to ionizing
     radiation in most countries.

1.   Pershagen G N Engl J Med. 1994 Jan 20;330(3):159-64. Residential radon
     exposure and lung cancer in Sweden.
2.   Lubin JH, et al. Int J Cancer. 2004 Mar;109(1):132-7. Risk of lung cancer and
     residential radon in China: pooled results of two studies.
3.   Krewski D, et al. Epidemiology. 2005 Mar;16(2):137-145. Residential Radon and
     Risk of Lung Cancer: A Combined Analysis of 7 North American Case-Control
     Studies.
Take-home Points:

   RID YOUR HOUSE OF RADON and
   Air Pollution
1. As far as possible get fresh air
2. Every room in the house should have
   fresh air.
     Open your windows
     Walk in open, fresh air
Nutrition
   Nutrition
            Western Diet increases
               Breast Cancer
 Asian countries, such as Japan, have low
  rates of breast cancer, while Western
  countries have breast cancer rates that are
  many times higher.
 When Japanese girls are raised on
  westernized diets, their rate of breast
  cancer increases dramatically.
   Armstrong B, Doll R. Int J Cancer 1975;15:617-31.
    Environmental factors and cancer incidence and mortality in different countries, with special
    reference to dietary practices.
   Hirayama T. Prev Med 1978;7:173-95. Epidemiology of breast cancer with special reference to
    the role of diet.
   McCann SE, et al. Int J Cancer. 2004 Sep 1;111(3):440-3. Dietary lignan intakes and risk of
    pre- and postmenopausal breast cancer.
   Freudenheim JL, et al. J Natl Cancer Inst. 1996 Mar 20;88(6):340-8. Premenopausal breast
    cancer risk and intake of vegetables, fruits, and related nutrients.
   Creton S, et al. Toxicol Sci. 2005 Jan 5. A mechanistic basis for the role of cycle arrest in the
    genetic toxicology of the dietary carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine
    (PhIP
   Weisburger JH. J Am Diet Assoc. 1997 Jul;97(7 Suppl):S16-23. Dietary fat and risk of
    chronic disease: mechanistic insights from experimental studies.
High Fat Diet Increases Risk
 for Most Common Cancers
        1. High dietary fat increases the
           risk of prostate cancer
        2. Diets high in animal fat
           significantly increases the risk
           for breast cancer.

           Fleshner, N., et.al. Dietary Fat and Prostate
            Cancer. Journal of Urology. 6/11/2004
           Armstrong B, and Doll R. Int J Cancer 1975;15:617-
            31. Environmental factors and cancer incidence and
            mortality in different countries, with special reference
            to dietary practices.
           Dietary fat and mammary carcinogenesis. Rose DP,
            et al. International comparisons of mortality rates for
            cancer of the breast, ovary, prostate, and colon, and
            per capita food consumption. Cancer 1986;58:2363-
            71.
Help your body fight cancer
          with a
  Low Saturated Fat Diet
In post-menopausal women, the higher the
saturated fat in the diet:
  The shorter the breast cancer survival
  The higher the rate of metastasis
Take Home Point: Improve Cancer
Survival by decreasing dietary fat.
Verreault R, Brisson J, Deschenes L, Naud F, Meyer F, Belanger L. Dietary fat in relation
to prognostic indicators in breast cancer. J Natl Cancer Inst 1988;80:819-25.
Jaiswal McEligot A, et al. Nutr Cancer. 2006;55(2):132-40. Dietary fat, fiber, vegetable,
and micronutrients are associated with overall survival in postmenopausal women
diagnosed with breast cancer.
 Help your body fight cancer
             with a
High-fiber, Vegetable-rich Diet
  In post-menopausal women, the higher the
    fiber and vegetable content:
     The longer the breast cancer survival
   Take Home Point: Improve Cancer
   Survival by increasing dietary
   vegies.

   Jaiswal McEligot A, et al. Nutr Cancer. 2006;55(2):132-40. Dietary fat, fiber,
   vegetable, and micronutrients are associated with overall survival in
   postmenopausal women diagnosed with breast cancer.
Help your body fight cancer
     by Losing weight
while eating a low-fat diet
 Women in the highest tertile of BMI
  had a 1.9-fold higher risk of dying from
  their breast cancer compared with those
  at the lowest tertile.
 2.0-fold higher risk for the highest tertiles
  of total fat, saturated fat, and
  monounsaturated fat intake.
   Zhang S, et al. Cancer 1995 Jul 15;76(2):275-83. Better breast cancer survival for
    postmenopausal women who are less overweight and eat less fat. The Iowa Women's Health
    Study.
      Good Fats Lower
       Risk of Cancer
 Omega 3-oils prevent cancer.
 Best source of omega 3 oils:
   Flax seed, walnuts, olive oil
Cooking Meat and
Cancer
  Cooking meat produces the dietary
   carcinogen 2-amino-1-methyl-6-
   phenylimidazo[4,5-b]pyridine (PhIP).
  RESULT: Mutates DNA until p53
   overwhelmed.
 FINAL RESULT: Prostate, Colon and Breast
   cancer.

    Creton S, et al. Toxicol Sci. 2005 Jan 5. A mechanistic basis for the role
     of cycle arrest in the genetic toxicology of the dietary carcinogen 2-amino-
     1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP).
                    Plant Food
                   versus Meat
 Cancers of the colon and prostate are
  nearly 2x as common in non-vegetarians
  vs. vegetarians.

 Frequent beef consumers also have
  higher risk of bladder cancer.

 Fraser GE. Am J Clin Nutr. 1999 Sep;70(3 Suppl):532S-538S. Associations between diet and
 cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California
 Seventh-day Adventists.
Meat Increases risk
of Colon Cancer
  A diet rich in meat increases
   growth of clostridium bacteria.
       Convert primary bile acids to
        carcinogenic secondary bile acids
         RESULT: Higher rates of Colon Cancer

 1.   Pai R, et al. Mol Biol Cell. 2004 May;15(5):2156-63. Epub 2004 Mar 5. Deoxycholic acid
      activates beta-catenin signaling pathway and increases colon cell cancer growth and
      invasiveness.
 2.   Kitahara M, et al. Microbiol Immunol. 2001;45(3):263-6. PCR detection method of
      Clostridium scindens and C. hiranonis in human fecal samples.
 3.   Rastall RA. J Nutr. 2004 Aug;134(8 Suppl):2022S-2026S. Bacteria in the gut: friends and
      foes and how to alter the balance.
FIBER FUN:

              Fiber speeds the passage
               of food through the colon.
              Fiber promotes growth of
               healthy gut bacteria
                 Reduces production of
                  carcinogenic bile acids.

               World Cancer Research Fund. American Institute of
               Cancer Research. Washington, DC: 1997. Food,
               Nutrition, and the Prevention of Cancer: A Global
               Perspective.
Milk Increases Prostrate
       Cancer Risk

 Numerous studies show that:
   Milk consumption significantly increases
    the risk of prostate cancer


 Qin, Li-Qiang, et.al., Milk Consumption Is a Risk Factor for Prostate
 Cancer: Meta-Analysis of Case-Control Studies. 5/07/04. Journal:
 Nutrition and Cancer. 48 (1): 22-27.
Soy Milk an Alternative to COWS MILK
 Lowers RISK OF PROSTATE
         CANCER!!!
   Soy Isoflavanoids are antioxidants
   Soy lowers the risk of prostate cancer
   Shown to slow cancer progression
  “You want me
to give up what?”
       Legumes and Fruit
          Protective

 Legumes (peas, lentils, garbanzos (chick peas), kidney
  beans…) decrease risk of colon and
  pancreatic cancer.
 Fresh and dried fruit lower risk of Lung,
  Prostate, and Pancreatic cancers.
  Fraser GE. Am J Clin Nutr. 1999 Sep;70(3 Suppl):532S-538S.
  Associations between diet and cancer, ischemic heart disease,
  and all-cause mortality in non-Hispanic white California Seventh-
  day Adventists.
 Fruits and Vegetables and
Pancreatic Cancer Prevention
   Prospective cohort of 36,616 women and
    45,306 men.
   Subjects with the highest amount of dietary
    folate intake were 75% less likely to develop
    pancreatic cancer.
   NO benefit from folate suplement or folate-
    fortified foods!

     Journal of the National Cancer Institute 2006;(98):407-413.
         Black Beans
       Help Fight Cancer
Chemicals known as tannins found in
black-bean inhibit colon, breast and
prostate cell proliferation.

TAKE HOME POINT: Eat your black
beans and FIGHT CANCER GROWTH.
Cancer Lett. 2005 Feb 10;218(2):153-62. Inhibition of Caco-2 colon, MCF-7 and Hs578T
breast, and DU 145 prostatic cancer cell proliferation by water-soluble black bean
condensed tannins.
Foods that Fight the
Growth of Prostate Cancer
  Avocado
    Inhibits prostate cancer cell growth
  Pomegranates
    Suppress prostate cell growth proliferation




 1.   Qing-Yi, Lu, et.al. Inhibition of prostate cancer cell growth by an
      avocado extract: role of lipid-soluble bioactivity. Journal of Nutritional
      Biochemistry. 16(1). 1/29/05.
 2.   Pomegranate Extracts Potently Suppress Proliferation, Xenograft
      Growth… Journal of Medicinal food. 4/12/2004, 7(3); 274-283.
Antioxidants Lower Risk
    of Breast Cancer
 Antioxidants stabilize DNA.
 5 Servings of Fruits and Vegetables per
  day lower the risk of Breast Cancer.
 Best results with fruits and vegetables high
  in Vitamin A and vitamin C.

   Zhang S, et al. J Natl Cancer Inst. 1999 Mar 17; 91(6):547-56. Dietary
    carotenoids and vitamins A, C, and E and risk of breast cancer.
       Raw versus Cooked
 Raw vegetables high in antioxidants
  vitamin C, folate, β-carotene, and zinc
  decrease risk of breast cancer.
 However: Cooked vegetables do not
  protect DNA  Breast Cancer
    Take Home Point: As far as
    possible eat raw vegetables and
    fruits and LOWER risk of CANCER.
   Adzersen KH, et al. Nutr Cancer. 2003;46(2):131-7. Raw and cooked
    vegetables, fruits, selected micronutrients, and breast cancer risk: a case-
    control study in Germany.
Do Antioxidant Supplements
  lower the risk of Breast
          Cancer?
                                    NO!
 Vitamin A, C, E supplements do NOT
 prevent breast cancer.

 Take Home Point: Help your body
 prevent cancer by using whole
 fruits and vegetables.
 Freudenheim JL, et al. J Natl Cancer Inst. 1996 Mar 20;88(6):340-8.
 Premenopausal breast cancer risk and intake of vegetables, fruits, and related
 nutrients.
Plant Based Diet
           Lignans are found in plant
            products.
           Elevated dietary amounts
            associated with lowered risk
            of breast cancer.
           Lignans lower estrogen.
            Take Home Point: Elevated
            lignans prevent breast
            cancer.
            McCann SE, et al. Int J Cancer. 2004 Sep
            1;111(3):440-3. Dietary lignan intakes and risk of
            pre- and postmenopausal breast cancer.
Pickling and Spices
Increase the Risk of
Stomach Cancer
  Spices
  Pickling with vinegar
  Salt in high quantities > 3g/day increase
   the risk of stomach and intestinal cancer



  Ernst P. Aliment Pharmacol Ther. 1999 Mar;13 Suppl 1:13-8. Review
  article: the role of inflammation in the pathogenesis of gastric cancer.
Take-home Message:
           The more closely
           your diet resembles
           the original diet in
           Eden, of fresh
           fruits, grains, nuts,
           and vegetables, the
           lower your risk of
           cancer.
           (Genesis 1:29)
Temperance
Alcohol is Damaging
           Alcohol increases DNA
            mutations:
             RESULT: Increased risk of
              cancer of the lip, mouth,
              throat, larynx and
              esophagus.
             More than additive risk
              when combined with
              tobacco.
           National Health and Medical Research Council
           (NHMRC) (2001). Australian Alcohol Guidelines:
           Health Risks and Benefits. NHMRC, Canberra.
Alcohol increases
Liver Cancer
         Alcohol and other causes of
          hepatitis increase the risk of
          liver cancer.


          O'shea RS, McCullough AJ. Clin Liver Dis. 2005
          Feb;9(1):103-34. Treatment of alcoholic hepatitis.
      Alcohol Raises
   Stomach Cancer Risk
 Alcoholic gastritis increases
  stomach cancer risk.


 Xiang Z, Si JM, Huang HD. World J Gastroenterol. 2004 Nov
  1;10(21):3212-4. Chronic gastritis rat model and role of
  inducing factors.
Alcohol Causes
Pancreatitis
 Alcohol is the #1 cause of pancreatitis, a
  precursor to pancreatic cancer.
 Smoking, alcohol, daily baby aspirin, and a
  low folate diet are the only known risk
  factors for pancreatic cancer.
     Suspected causes include physical inactivity,
      pesticide exposure, and refined carbohydrate.
   Jura N, et al. Cell Res. 2005 Jan;15(1):72-7. Chronic pancreatitis, pancreatic
    adenocarcinoma and the black box in-between.
   Michaud DS. Minerva Chir. 2004 Apr;59(2):99-111. Epidemiology of
    pancreatic cancer.
–   Schuermhamer, E. A prospective study of ASA use and the risk of pancreatic
    Cancer in women. National Cancer institute. 2003; 96;22-28.
   Journal of the National Cancer Institute 2006;(98):407-413.
Women are more sensitive
 to alcohol and tobacco
    Low-to-moderate use of alcohol
     increases risk of female breast
     cancer.

     TAKE HOME POINT: A glass of wine a
     day increases breast cancer risk.
1.   National Health and Medical Research Council (NHMRC) (2001). Australian Alcohol
     Guidelines: Health Risks and Benefits. NHMRC, Canberra.
2.   Alcohol in Australia: Issues and Strategies. (2001) Commonwealth Department of Health
     and Aged Care, Canberra.
3.   Laslett A, Donath S, and Dietze P (2002). Long term consequences of alcohol consumption.
     In: National Alcohol Research Agenda. Commonwealth Department of Health and Ageing,
     Canberra.
4.   Single E, Ashley M, Bondy S, Rankin J and Rehm J (1999). Evidence Regarding the Level
     of Alcohol Consumption Considered to by Low-Risk for Men and Women. Commonwealth
     Department of Health and Aged Care, Canberra.
Alcohol and Breast Cancer
  Women who consume more than 1
   drink per day had 20% higher
   circulating estrogen levels compared
   with non-drinkers, which means
   higher risk of breast cancer.
  consumption of fruits, vegetables,
   and whole grains showed inverse
   associations with androstenedione
   levels.
    Maskarinec G, et al. Public Health Nutr. 2006 Oct;9(7):875-81. Alcohol and dietary fibre intakes
     affect circulating sex hormones among premenopausal women.
    Kaaks R, et al. J Natl Cancer Inst. 2005 May 18;97(10):755-65. Serum sex steroids in
     premenopausal women and breast cancer risk within the European Prospective Investigation

     into Cancer and Nutrition (EPIC).
Tobacco Increases the Risk
of the Following Cancers:
     Lung                                  Pancreas
     Oral Cavity                           Kidney
     Nasal Cavities                        Bladder
     Larynx                                Uterine
     Pharynx                               Cervix
     Esophagus                             Colon
     Stomach                               Myeloid Leukemia
     Liver
University of Texas M.D. Anderson Cancer Center. http://www.mdanderson.org,
acquired 3/05/05.
Short Tobacco
Smoke Exposure
  Tobacco smoke causes DNA deletions
       Result: CANCER
       ONLY 4 hours of intra-uteri cigarette smoke
        increases DNA deletions and cancer IN FETUS
  Second-hand tobacco smoke causes the same
   cancers as first-hand smoke.
   TAKE HOME POINT: Completely avoid
   tobacco exposure, especially if pregnant.

    Jalili T, et al. Cancer Res. 1998 Jun 15;58(12):2633-8. Cigarette smoke
     induces DNA deletions in the mouse embryo.
    Husgafvel-Pursiainen K. Mutat Res. 2004 Nov;567(2-3):427-45.
     Genotoxicity of environmental tobacco smoke: a review.
Caffeine may increase risk
of carcinogenesis
            Caffeine appears to
             deregulate cell
             cycle progression
             allowing cells with
             mutations to
             progress in the cell
             cycle.
              Qin J, et al. Anticancer Res. 2004 Sep-
               Oct;24(5A):2991-5. Down-regulation of
               cyclin E expression by caffeine promotes
               cancer cell entry into the S-phase of the cell
               cycle.
BMI and Cancer Risk
  High Body Mass Index (BMI)
   raises risk of breast cancer.
  Central obesity increases
   pancreatic cancer.
  Patel AV, et al. Cancer Epidemiology Biomarkers Prev. 2005
   Feb;14(2):459-66. Obesity, recreational physical activity, and risk
   of pancreatic cancer in a large u.s. Cohort.

  Shu XO, et al. Int J Cancer. 2001 Nov 1;94(3):449-55. Association
   of body size and fat distribution with risk of breast cancer among
   Chinese women.
  Take-home Message:

Practice Temperance:
  Avoid entirely substances harmful to the
  body and use judiciously those things
  which are beneficial.

 RESULT: Improved health and cancer
 prevention.
Rest
    Regular Sleep Decreases
    Cancer
 Regular sleep at night decreases
  risk of breast and colon cancer.
 Regular sleep increases melatonin,
  which is anti-estrogenic
      Leads to a normal cortisol cycle
          This helps regulate cancer-fighting natural
           killer cells.
 Take Home Point: Improve sleep
  habits and lower cancer risk.
   Stanford University Medical Center. 2003 October 1:
    http://mednews.stanford.edu. LINK BETWEEN SLEEP, CANCER
    PROGRESSION EXPLORED BY STANFORD RESEARCHER
Get Dark Sleep
  Being totally blind = 36% lower risk of
   breast cancer in women.
  Early blindness in women is especially
   protective against breast cancer (49% lower
   risk than sighted women).
  Nighttime exposure to light interrupts
   melatonin secretion.


   British Journal of Cancer March 2001;84:397-399. Sleep In TOTAL Darkness to Decrease
   Cancer Risk
Sleep in Total Darkness
and Male Cancer
 Blind men had a lower incidence of
  prostate, stomach, colon, rectum, skin
  and lung cancers.


   Take Home Point: Sleep in total
   darkness and decrease cancer
   risk
Science News October 17, 1998 154:248-250.
Night Shift Workers
         Nurses Health Study:
         Irregular hours of sleep in
          rotating shift workers were
          found to have increased
          risk of breast and colorectal
          cancer.
         TAKE HOME POINT: As
          far as possible get regular
          hours of sleep.
           Schernhammer ES, et al. J Natl Cancer Inst. 2001 Oct
            17;93(20):1563-8. Rotating night shifts and risk of breast
            cancer in women participating in the nurses' health
            study.
            Comment in:
             J Natl Cancer Inst. 2001 Oct 17;93(20):1513-5.
             J Natl Cancer Inst. 2002 Apr 3;94(7):530; author reply
                 532-3.
             J Natl Cancer Inst. 2002 Apr 3;94(7):531-2; author
                 reply 533-4.
           Schernhammer ES, et al. J Natl Cancer Inst. 2003 Jun
            4;95(11):825-8. Night-shift work and risk of colorectal
            cancer in the nurses' health study.
Take-home Message:

  GET Regular Sleep at night,
  without light, and decrease the
  risk of multiple types of
  cancer.
Exercise
Exercise Lowers Risk of
Breast Cancer
            STUDY: 72,608 women
             followed for five years;
             results showed that
             those women who were
             most physically active
             had 29% lower
             incidence of breast
             cancer.
              Patel AV, et al. Cancer Causes Control. 2003
               Aug;14(6):519-29. Recreational physical
               activity and risk of postmenopausal breast
               cancer in a large cohort of US women.
Exercise Lowers Colon
Cancer Risk
 Increasing hours of exercise
  directly lowered colon cancer
  risk.
      Exercise decreases inflammation by
       lowering prostaglandin E2 levels in
       colorectal mucosa.
   Chao A, et al. Cancer Epidemiol Biomarkers Prev. 2004 Dec;13(12):2187-95. Amount, type,
    and timing of recreational physical activity in relation to colon and rectal cancer in older adults:
    the Cancer Prevention Study II Nutrition Cohort.
   Martinez ME, et al. J Natl Cancer Inst. 1999 Jun 2;91(11):950-3. Physical activity,
    body mass index, and prostaglandin E2 levels in rectal mucosa.
Non-strenuous Exercise is
Best
  Exercise need not be
   strenuous in order to
   see the anti-cancer
   benefit.


    McTiernan A, et al. JAMA. 2003 Sep
     10;290(10):1331-6. Recreational physical activity
     and the risk of breast cancer in postmenopausal
     women: the Women's Health Initiative Cohort
     Study.
    Knight JA , et al. Am J Epidemiol. 2005 Dec
     1;162(11):1114-22. Epub 2005 Oct 5. Light and
     exercise and melatonin production in women.
     Take-home Point:

 Exercise prevents cancer. It should be
  regular but need not be strenuous.
 Regular, brisk walking is ideal.
  Sunshine
Sunshine
Vitamin D
and Sunshine

 Sunlight is necessary for the conversion of 7-
  dehydrocholesterol in the dermis to 25-
  hydroxycholecalciferol which is, in turn,
  converted to 1,25-dihydroxycholecalciferol by
  the kidneys.
Vitamin D Prevents Cancer

  High levels of Vitamin D are associated
   with increased apoptosis in rectal
   epithelium.
  Take Home Point: Vitamin D helps the
   body rid itself of old or damaged cells
   so that they do not live on to become
   cancer.

    Miller EA, et al. Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):525-8.
     Calcium, vitamin d, and apoptosis in the rectal epithelium.
Sunshine Helps the
Body Fight Cancer
          Vitamin D inhibits
           angiogenesis and
           adjacent tissue
           invasion.
          Lower rates of lung
           cancer metastasis.


           Nakagawa K, et al. Carcinogenesis. 2005
           Feb 17;22-oxa-1α,25-dihydroxyvitamin D3
           inhibits metastasis and angiogenesis in
           lung cancer.
Sunshine Lowers Breast
     Cancer Risk
 Women with a Vitamin D gene mutation
  have 2X the risk of developing breast and
  other cancers.

   BBC News. http://news.bbc.co.uk/1/hi/health/3542344.stm
        Vitamin D and
    Breast Cancer Survival
             Norwegian Study
 Premenopausal women diagnosed with
  breast cancer in the summer had a 15-
  25% lower relative risk of dying from their
  disease compared with those diagnosed
  during the winter.

   Porojnicu AC, et al. Breast Cancer Res Treat. 2006 Sep 21; Changes in risk of
    death from breast cancer with season and latitude : Sun exposure and breast

    cancer survival in Norway.
        Vitamin D and
    Breast Cancer Survival
              Norwegian Study
 Those living in the southeast region of
  the country with its 1.5X higher annual
  UV exposure also had a 25% lower RR
  of death.
 No benefit from Vitamin D food
  supplement during winter for northerners.
   Porojnicu AC, et al. Breast Cancer Res Treat. 2006 Sep 21; Changes in risk of
    death from breast cancer with season and latitude : Sun exposure and breast

    cancer survival in Norway.
              Sunshine and
             Prostate Cancer
 Vitamin D has been shown to reduce
  cytokine-related inflammation associated
  with prostate cancer carcinogenesis.
   Nonn L, et al. Cancer Res. 2006 Apr 15;66(8):4516-24. Inhibition of p38 by vitamin
    D reduces interleukin-6 production in normal prostate cells via mitogen-activated
    protein kinase phosphatase 5: implications for prostate cancer prevention by
    vitamin D.
                Melatonin and
                Breast Cancer
 Melatonin has been found not only to
  neutralize the effects of estrogens on the
  breast, but also to block the local biosynthesis
  of estrogens from androgens
 Similar effect to estrogen blocking medications

   Cos S, et al. Cancer Detect Prev. 2006 Apr 26. Estrogen-signaling pathway: A
    link between breast cancer and melatonin oncostatic actions.
  Melatonin and Cancer

 Melatonin helps fight breast and colon
  cancer, and possibly cancers of the
  prostate, stomach, rectum, skin and
  lung.
 Early morning sunlight is particularly
  important for increased secretion of
  melatonin secretion at night.
Sunshine Prescription:




            Medline Plus.
            http://www.nlm.nih.gov/medlineplus/ency/article/0
            02405.htm. Acquired 3/8/05.
Trust in
 Divine
 Power
Mental and Physical Health
         Interact
 1. Mental stress raises inflammation:
       ―To balance the immune system, one must
       balance the mind and emotions.‖
 2. Inflammation increases cancer
    Take Home Point: Mental imbalane can
    increase the risk of cancer.

   TAKE HOME POINT: ―A merry heart doeth good like
   a medicine, but a broken spirit drieth the bones.
   Veldhuijzen. Ann Rheum Dis. 2005 Feb 11. Increased C reactive protein in
   response to acute stress in patients with rheumatoid arthritis.
Spiritual Health (Faith) Helps
   the Body Fight Cancer
  Self-reported or perceived 'religiousness', as
  defined in the study was associated with a 30%
  improvement in cancer survival.

 Take Home Point: Improved spiritual health
   (trust) helps the body fight cancer.
  Kune GA, et al. J R Soc Med. 1993 Nov;86(11):645-7. Perceived religiousness is protective for
  colorectal cancer: data from the Melbourne Colorectal Cancer Study.
The Perfect Triangle

  Physical, Mental and Spiritual Health
   work together to create ―WHOLE
   PERSON HEALTH‖
  When one aspect is defective or missing,
   then the other parts are affected.
“Faith cometh by hearing and hearing
  by the word of God.”
                         Romans 10:17
  In summary:
1. Healthy choices in lifestyle can exhibit a
   great influence to decrease cancer
   incidence.

2. Cancer survival can even be affected by
   healthy changes in diet and lifestyle.

3. These principles can be remembered with
   the acronym, ‗W A N T R E S Ttm‘.
And Remember: Health Change is Progressive
NOTE:

 CAUTION: These talks are for your
  information only and do not serve to
  create a doctor-patient relationship, if you
  are ill or on medication and wish to
  significantly change your lifestyle you
  should do so under the direction of your
  regular physician.
 Copyright 2006.
 Federal law and Christian ethics dictate that no
 part of this presentation may be reproduced or
 used in any form or by any means, electronic
 or mechanical, without permission of the
 publishers.

								
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