Cancer

Cancer is the second leading cause of death in North America (after heart and other cardiovascular diseases) with lung cancer heading the list, followed by bowel, breast, prostate, pancreas and other malignancies.

What is cancer?
 Abnormal growth of cells (clone of cells), not under the control of the body.
 It kill by steeling the space and nutrition from the normal cells.

A cancer cell is a unregulated cell with damaged DNA.

How cancer occurs
  1. Something damages the cell DNA Viral, Chemical, radiation - call carcinogen (gen-Genesis, carcino cancer). We call this Initiation
  2. Your immunity is damaged or blocked or overwhelmed
  3. Some other agents promotes the growth of this abnormal clone of cells call
cancer/tumor/malignancy  -a cancer growth factor usually referred to as a carcinogen but tumor promoters is more appropriate.

A promoter can cause transformed cells to proliferate and form a tumor, but in itself it is neither mutagenic nor carcinogenic. Moreover, it must be applied continuously to have a biological effect; if the promoting stimulus is removed, its effects are reversible.

In Prostate Cancer one of the treatments is removal of the testicals.  Testosterone is a promoter of Prostate cancer.  It doesn't cause it.  The same is true with estrogens and breast cancer.

At present several factors in the diet are seen as tumor promoters or antipromoters.  The item most clearly established as a promoter is dietary fat.

Experimental studies show that  certain dietary fats acts as a tumor promoter or enhancer, but some evidence indicates that fat may also have a role in cancer initiation.  

Statistics

Estimated New Cases and Deaths in the United States for Major Forms of Cancer--1992 

Type or Cancer Number of Cases  Number of Deaths
All sites 
Lung
Colon and rectum
Breast    
Prostate
Urinary tract
Uterus 
Oral cavity and pharynx
Skin     
Pancreas
Leukemia
Ovary 
All other sites
1,130,000   
168,000 
156,000 
181,000@
132,000 
78,100 
45,500@
30,300 
32,000*
 28,300 
 28,200 
 21,000 
 229,600 
520,000
146,000
58,300
46,300
34,000 
20,200
10,000
7,950
8,800**
25,000
18,200
13,000
132,250

@ lnvasive cancers only more than 20,000 carcinomas in situ of the breast and 55.000
carcinomas in situ of the cervix are estimated·
* Melanoma only; more than 600,000 non- melanoma skin cancers
are estimated.
** Melanoma 6700; other skin cancers 2100.
(Boring CC, Squires TS, Tong T· Cancer statistics, 1992. CA 1992;
42:19. Based on incidence data from National Cancer lnstitute SEER
program 1986-1988 and mortality data from the National Center for
Health Statistics. All figures are rounded.)
 

Since 1950  the incidence of cancer in the United States climbed about 40 percent.

Lung cancer, most of it resulting from cigarette smoking, caused the biggest carnage.  Its incidence rose 209 percent in men and 451 percent in women.  But even excluding lung cancer, the cancer rate rose 22.6 percent.

Between 1974 and 1986 the age-adjusted rates of these cancers increased:
 Breast cancer up 18.4 percent;
 Brain up 22.3 percent;
 Bladder up 10.3 percent;
 Liver up 16.2 percent;
 Thyroid up 16.7 percent;
 Colon up 13.9 percent.
 The list goes on.

 Yet during that same time the incidence of some cancers dropped.
 Stomach cancer was down 20 percent;
 Cervical cancer down 36.1 percent;

Scientists say these numbers reveal that there are indeed powerful environmental causes of cancer.

World wide:

 The most common fatal form was stomach cancer (prevalent in Asia), but lung cancer has risen rapidly, because of the spread of cigarette smoking in developing countries, to become the leading fatal cancer in the world today.  Also on the increase is the third-greatest killer, breast cancer, particularly in China and Japan.  The fourth on the list is colon or rectum cancer, a disease that mainly strikes the elderly.

 One of the most informative comparisons is between the U.S. and Japan.  Both countries have similar levels of industrialization and education, high medical standards and good vital statistics.
Surprisingly, although the overall cancer rates are similar, the two countries yield mirror images when specific types of cancer are compared.  For example, cancers of the colon, breast, and prostate are common in the U.S. but rare in Japan.  Conversely, cancer of the stomach is common in Japan but rare in the U.S.  Are the environmental factors enhancing breast, colon and prostate cancer more prevalent in the U.S., or are factors that protect against such cancers more prevalent in Japan?

One might answer that the differences are based on genetic differences between the two populations.  That hypothesis is refuted by the data on migration from one country to another.
They show that the worldwide geographic variation in organ-specific cancer rates can be attributed to environmental factors rather than genetic ones.  For example, within two generations Japanese immigrants in Hawaii and California had breast-cancer rates approaching those of the Hawaiian white population and significantly higher than those of native Japanese.  Conversely, gastric-cancer rates became significantly lower among Japanese Hawaiians than among native Japanese.  Increases in breast-cancer rates were also found in populations emigrating from Poland, where the risk is low, to the U.S.

 For example, if Japanese people (who have low rates of breast and colon cancer but high rate so stomach cancer) move to the U.S., they acquire typical American cancer rates - high colon and breast cancer rates, low risks of stomach cancer.

A time-trend study that followed Japanese dietary habits and cancer deaths found that the mean per capita fat intake, which increased from 23 g/day in 1957 through 1959 to 52 g/day in 1973, was accompanied by a doubling of the total number of annual breast cancer deaths between 1957 and 1973.

For example, in developing countries as much as 80 percent of total calories comes from cereals and grains, which consist of complex carbohydrates.  With industrialization and economic advance the caloric intake shifts toward fats derived from meat and vegetable oil. The consumption of sugar (simple carbohydrate) also increases.  Such changes are taking place now in a number of countries, including Iceland, Italy, Greece and Japan.  As the changes have occurred, rising rates of breast and colon cancer (and of prostate cancer in certain places) have been observed.  The same changes have been observed in the U.S.  Since 1900, for example, the intake of animal and vegetable fats has risen by 40 percent while the consumption of potatoes has declined by 60 percent and of flour by 50 percent.  Since 1930 the incidence rates of breast, colon and prostate cancer have gradually increased.  On the other hand, deaths from gastric cancer have fallen dramatically.  The drop has been attributed to the fact that refrigeration has largely replaced salting, pickling and smoking in the preservation of food.

 Sidney S. Mirvish of the Eppley Institute for Research in Cancer in Omaha has shown that nitrosation reactions do not proceed in the presence of ascorbic acid (vitamin C), which blocks the conversion of nitrates into nitrites.

Several foods consumed by populations at high risk for gastric cancer --among them smoked fish (in Japan) and fava beans (in Colombia)-- have been shown to yield mutagens after nitrosation. These same populations consume small amounts of fresh fruit and vegetables and therefore take in low levels of vitamin C, suggesting that gastric cancer may result from the formation in the stomach of carcinogenic nitrosamines or nitrosamides from dietary nitrate in the absence of vitamin C.  In no case, however, have the hypothetical "natural' nitrosated substances to which gastric cancer has been attributed been isolated in people or in experimental animals.

The effects of, pickling and smoking foods have also been explored experimentally.  These methods of preservation create conditions under which nitrates can be converted readily into reactive nitrites; these in turn have been shown to combine with appropriate substrates (in the test tube) to form carcinogenic nitrosamines and nitrosamides.

Preventable

A majority of the causes are know and preventable

The best estimate of the causes of cancer deaths.

Tobacco     35%
Diet  30%
Infection  10%
Reproductive and sexual behavior  7%
Occupation   4%
Alcohol 3%
Geophysical factors' 3%
Pollution 2%
Medicines and medical procedures 1%
Food additives  <1%
Industrial products      <1%
Unknown   4%

Fats

Most experimental studies suggest that dietary fat acts as a tumor promoter or enhancer, but some evidence indicates that fat may have a role in cancer initiation.

Animal studies have also shown that the type as well as the amount of dietary fat governs the development of mammary, colon and pancreas tumors.  High-fat diets rich in certain fatty acids promote the formation of tumors, whereas similar diets high in other fatty acids do not.
The difference seems to be in the chemical structure of the fatty acids.  High-fat diets rich in linoleic acid (s-6 or n-6 polyunsaturated fatty acids) (found in corn, safflower, sunflower and other common plant oils) act as promoters; similar diets rich in oleic acid (monounsaturated fatty acid) (from olive oil) and eicosapentaenoic acid (from fatty fishes and marine mammals) do not act as promoters.

These findings in animals may help to explain several epidemiological enigmas, including the low rates of breast and colon cancer among the Eskimos of Greenland.  They have a diet extraordinarily high in fat (60 percent of calories), but the fat is derived almost entirely from fish and marine mammals.  Similarly, the moderate rates of breast cancer in such countries as Greece and Spain, where fat intake is fairly high (32 percent of calories), may be due to the fact that olive oil is a major source of fat in Mediterranean diets.

Epidemiologic data show a relationship between the amount of saturated fat and colon cancer.

Virus Connection

Among the viruses strongly linked with human cancers:

Virus are non living particle of DNA with a capsule that multiply in a cell and either destroy the cell or damage it.

1.  Epstein-Barr virus, that causes the disease known as infectious mononucleosis.  This latter virus is also suspected of causing the malignancy called Burkitt's lymphoma, prevalent in Africa, and a cancer of the nose and throat that commonly occurs in China.
2. Papilloma viruses:  Cervical cancers
3. Another human cancer related to a virus infection is a liver carcinoma that sometimes
follows a HEPATITIS-B infection.
4. Another link established between a human cancer and a virus is that between T-cell leukemia and a form of RETROVIRUS called HTLV-l;  the cancer appears to be endemic in certain parts of Japan, the West Indies, and the southeastern United States.
5. Childhood Leukemias - Good evidence that this is a viral illness transmitted thought the Genetic material from the parents

  -Children who eat too many hot dogs may be increasing their risk of developing  childhood leukemia, a study in the medical journal  "Cancer Causes and Control", published by the Harvard School of Public Health, says.
     A 10-year study at the University of Southern California found that children who ate more than  12 frankfurter sausages a month and whose fathers had a history of similar consumption had 9 times  the normal risk of leukemia.
     The report added that while it was clear that  the risk of leukemia increased with the consumption of hot dogs, "the risks did not become  large until consumption of 12 hot dogs per month  for both children and fathers.
     The USC team studied 232 Los Angeles children  up to the age of 10 who had developed childhood leukemia and 232 who had not.
     They studied a variety of possible causes of  childhood leukemia, including parents' occupations, environmental factors, exposure to  electro-magnetic fields, and food.
     In particular, they said, they looked at a  variety of processed meats that are treated with nitrites to preserve them. The meats included  bacon, sausage, ham, salami, pastrami, lunch meat, corned beef and bologna, as well as hot dogs.
     Of all the factors studied, however, only the hot dogs showed an increased risk of leukemia.   "It was a real surprise. It just popped out; we  weren't looking for it," Peters said.
       Peters and his team suggested that fathers might be passing the leukemia genes to their children.

Remember the 3 criteria for cancer
  1. Carcinogen to damage the DNA - virus in the meat damaged the Father's DNA
  2. Reduced immunity - poor diet few protective foods
  3. promoter -  high fat diet  

CURED MEAT/BROILED MEAT/CANCER IN CHILDREN

Children whose mothers consumed cured or broiled meat during their pregnancy  are at greater risk of the later development of one of several types of cancer.  Childhood brain tumors were more common in children whose mothers had consumed one or more hot dog[s] per week during the pregnancy.

Children who consumed hamburgers once or more each week are at increased risk of acute lymphocytic leukemia; hot dog consumption by the child also increases the risk of brain tumors.

Earlier studies have shown a relationship between nitrite and nitrosamine intake and cancer, ant it is felt that these substances are the cause of the increased risk (Cancer Causes and Control 5:141-148, 1994).

LUNG CANCER/MEAT INDUSTRY
Studies from Denmark, Sweden, England and Wales have shown an increased incidence of lung cancer in meat cutters and butchers.  A study from Baltimore, Maryland, demonstrates an unusually high incidence of lung cancer in men who worked in slaughterhouses, chicken-slaughtering plants, meat-packing plants and the meat department of supermarkets. This excess incidence was not related to smoking.  The researchers feel that workers may be exposed to viruses which produce lymphoma or leukemia in animals, and to papilloma viruses, which are associated with the development of cancer. (Journal of the National Cancer
Institute 83(18)1337-1339, September 18, 1991)

The body has mechanisms to combat the cell that develops DNA damage.
 1. Each cell can repair its own DNA
 2. The Immune system recognizes damaged cell and destroys them by the T Cell
system. The function of the immune system most recently discovered is the system's ability to recognize and eliminate the abnormal (mutant) cells that frequently arise within the body.  These mutant, or cancer, cells may occur spontaneously, or they may be induced by certain viruses (oncogenic)
viruses) or chemicals (mutagens).  An immune system that is functioning properly can usually recognize and dispose of such cancer cells by means of a process called immune surveillance. The malfunction of this process may result in the incidence of certain types of cancers.  

.3. Enzymes detoxify carcinogens.
 4. Antipromoters include dietary fiber; vitamins A, C and E; the trace element selenium, and certain compounds in such vegetables as broccoli, cabbage and cauliflower, which are called cruciferous vegetables because they are in the Cruciferae family of plants.
Evidence from clinical studies and laboratory experiments suggests that some of the vegetable compounds may act at more than one point in the carcinogenic sequence, affecting enzymes that detoxify initiating carcinogens and also serving as antipromoters.  In addition, as demonstrated in several studies the promoting effect of dietary fat can be modified by other dietary components, most notably fiber.

Vegetables contain a large number of substances, both micronutrients, such as
carotenoids and ascorbate, and other phytochemicals, such as phenols, flavonoids,
isothiocyanates, and indoles, with a variety of potent anticarcinogenic properties. The steps from procarcinogen to cell replication or (differentiation can be broadly considered as follows:
1.procarcinogen is activated to ultimate carcinogen (either of which may be solubilized and excreted);
2.carcinogen passes through cell and nuclear membranes;
3.Carcinogen interacts with DNA;
4. DNA synthesis and replication (or DNA repair) occur; cell
replication with abnormal DNA and abnormal protein synthesis (or cell redifferentiation) result.
At almost every one of these steps, one or more known phytochemicals can alter the likelihood of carcinogenesis.
 5. Antioxidents (procarinogen are frequently oxidized carcinogen), vitamins A, C and E; the trace element selenium. ( oxidize a chemical reaction of adding a electron)
 6. Protease inhibitors
Another class of potential dietary antipromoters has been studied in detail by Walter Troll of the New York University School of Medicine.  Found in beans and plant seeds, they are protease inhibitors:  they counteract the effects of enzymes that digest proteins and presumably help a tumor to invade neighboring tissue.

Common types of cancer and how prevented

Lung                                 168,000                 146,000

 At least 14 studies have demonstrated a risk of lung cancer in nonsmoking wives exposed to the secondhand smoke of their husbands.  Passive smoking has been found to increase the risk of leukemia, lymphoma, and cancer of the breast and uterine cervix.
 The risks of passive smoking extend beyond cancer. It is estimated that tobacco smoke in the home and work place could be responsible for the deaths of 46,000 nonsmokers annually in the United States. Most of these (32,000) are due to heart disease, making passive smoking the third leading preventable cause of death after smoking and the consumption of alcohol.

Colon and rectum             156,000                   58,300

With respect to colon cancer, it has been postulated that total dietary fat influences the metabolic activity of fecal bacteria and the concentration of sterol substrates in the large intestine. As a consequence, tumor-promoting substances (secondary bile acids) may be produced from bile acids within the lumen of the colon.

As suggested by some epidemiologic data, experimental studies indicate that degree of saturation and chain length of dietary fats can influence tumorigenesis.

Women who consumed red meat daily, compared with once a month, had a 2.5 times greater risk for colon cancer.

 The interest in defining the relation between dietary fiber and cancer can be traced to the early 1970s, when Burkitt cited international epidemiologic data indicating that fiber-rich diets played a protective role in cancer of the large bowel.  This study and others found that the lowest rates of colon cancer are in African and Asian countries, where high-fiber diets are consumed, and that the highest colon cancer rates are in western societies, where refined carbohydrates have commonly replaced naturally occurring fiber-rich foods and where intake of fiber is consequently low. For example, the Chinese diet contains three times more fiber than the typical American diet, and the colon cancer incidence rate in China is approximately two thirds lower than that of the United States.  Chinese also consume about 33% less protein, 50% as much fat, and 30% more calories based on reference body weights than do Americans, indicating that these factors may influence colon cancer risk.

Studies comparing rural Finland and New York and Finland and Denmark

 The protective role of dietary fiber in colon cancer can be seen when comparing populations that consume relatively comparable high levels of fat (more than 30% of total calories), but whose diets differ with regard to fiber intake. Studies comparing rural Finland and New York and Finland and Denmark found that Finnish populations, with an average intake of approximately 31 g of fiber per day had a lower risk for developing colon cancer than the other two populations, which consumed no more than 17 g of fiber per day,5 despite a similar high intake of fat 34-37% of total.
 
  Several mechanisms by which dietary fiber is believed to protect
against colon cancer have been suggested:
(1) by increasing fecal bulk, which, in turn, dilutes the concentrations of carcinogens in the feces;
(2) by changing bacterial composition in the colon, which leads to deactivation of carcinogenic metabolites by binding to carcinogens, co carcinogens, or both, or promoters in the bowel;
(3) by inducing Structural and functional chemical changes in the gut mucosa, including altering rates of cell proliferation;
(4) by altering bile acid metabolism;
(5) by reducing fecal pH and
(6) by accelerating the transit time of fecal material through the intestinal tracts other carcinogens from food or other sources have less contact with colon mucosa.

The most popular current hypothesis about the link between a high-fat diet and colon cancer is based on findings that a high fat intake results in increased secretion of bile acids (which help to digest fat) and alters the bacterial population in the large bowel, thereby enhancing the conversion of primary bile acids into secondary ones.  Secondary bile acids in turn are thought to be promoters of lesions that are already present in the large bowel.

Five studies have noted a positive association with egg consumption; four have shown an inverse association with fish or seafood consumption. (colon cancer)
 

Breast                               181,000@·                  46,300

Experimental studies using mouse mammary tumors showed that the amount of dietary fat consumed after, but not before, exposure to a chemical carcinogen led to enhanced tumor genesis and to the suggestion that fat affects promotion process of carcinogen sis rather than the initiation.

The role of fat in tumor initiation is suggested by more recent experimental data.
 

A time-trend study that followed Japanese dietary habits and cancer deaths found that the mean per capita fat intake, which increased from 23 g/day in 1957 through 1959 to 52 g/day in 1973, was accompanied by a doubling of the total number of annual breast cancer deaths between 1957 and 1973.

Increase risk
 1. Abortion
 2. Early onset of menstruation
 3. Late menopause

Decease risk
 Pregnancies
 Early Pregnancy

Some international studies suggest that high intakes of cereals may be inversely related to breast cancer incidence. In a study of 37 countries, a high correlation was observed between the incidence rates of colon and breast cancer in countries with high incidence rates of these types of cancer, a weak inverse correlation between cereal consumption and cancer incidence and a direct relation between high intakes of fat and animal protein were found.

In a comparison of 133 breast cancer patents and 218 healthy subjects, it was found:
  Low intake of the following in the breast cancer group.
1. Cereal products
2. Beta-carotene fruits
3. Vegetables
4. All vegetable products combined
5. Energy-adjusted intake of dietary fiber

 Several reports have indicated that laboratory rats fed a diet containing starch following the intake of a chemical carcinogen showed a significantly lower frequency of mammary tumors than rats fed a similar diet containing dextrose (a simple sugar) in place of starch.
 

{Studies by}(West et al., 1980; Lyon et al., 1980; Phillips et al., 1980; Eslstrom, 1980). Gaskill et al.  (1979)...., and they find that within the United States breast cancer mortality correlates more strongly with the consumption of milk fat than of other types of fat.

As little a 3 drinks (Alcohol) per week increased the risk of breast cancer.
 

Prostate                             132,000                   34,000

Several dietary studies of prostate cancer risk indicated a small to moderate positive relation between risk and consumption of fat or high-fat foods.

  A mechanism linking dietary fat to prostate cancer has not been hypothesized; however, the endocrine system has been implicated as a mediator of dietary influenced including fat.

Uterus                                 45,500·                  10,000

Recent evidence has strengthened the association between cigarette smoking and cancer of the uterine cervix.  As many as one third of the 12,000 new cases of cervical cancer in the United States each year are attributable to cigarette smoking. Women who smoke cigarettes have four times the risk of nonsmokers for developing cervical cancer.

Human papilloma                         Cervical
 

Skin                                    32,000*                   8,800**

  Sunlight combined with decreased protective foods

Pancreas                             28,300                   25,000

Associations between alcohol consumption and cancer vary by site and type of alcoholic beverage.  Alcohol intake is reported to be directly associated with cancers of the oral cavity, pharynx, esophagus, and larynx where alcohol interacts synergistically with smoking to increase risk. Primary liver rectal, pancreatic, and breast cancer also have been linked with alcohol intake.
 
 
  The protective anti-cancer effects of fruit and veggies

Low intakes of fruit and vegetables have been consistently linked to high cancer rates in many countries around the world. Yet, less than 10 per cent of North Americans eat the recommended 5-10 daily servings. The fruit and vegetables that appear most protective against cancer are raw, dark green leafy vegetables (such as spinach, kale and lettuce), cruciferous or cabbage-family types (such as brussel sprouts, cabbage, cauliflower, broccoli), and orange forms such as carrots, squash, citrus and other fruits. Different plant foods may protect against different cancers, for example:

* dark green vegetables may protect against lung cancer;

* cruciferous (cabbage family) vegetables and carrots appear
protective against colon cancer;

* citrus and other fruits rich in vitamin C may lower risks of mouth, larynx, stomach and esophageal tumors.

The constituents in plant foods thought to ward off cancer include antioxidants - such as vitamins C, E and carotenes (vitamin A precursors).  Other plant compounds such as indoles, flavones, phenols, coumarins, isothiocyanates, sterols and limonene may also play an anti-cancer role. Together, the plant components or phytochemicals that fight cancer have been dubbed "chemopreventive agents."
 

Laboratory studies also suggest an anticancer effect for flavones, indoles and isothiocyanates (nonnutritive compounds often called secondary plant constituents) derived from cruciferous vegetables.  The compounds apparently act by blocking the activation of hydrocarbon agents in the host. (Most carcinogens are consumed as inactive procarcinogens and must be activated by enzymes in the liver before they can react with the DNA of target cells.)

Overall, the epidemiological studies of beta-carotene are remarkably consistent in suggesting a protective effect on cancer risk. To date, more than 85 questionnaire studies of intake of  fruits and vegetables rich in beta-carotene in relation to risks  for cancer have been published, including more than 15,000  cases of cancer at 16 different Sites, conducted in more than a dozen locations within the United States and in 10 Other

" People can obtain all the necessary vitamins, minerals and other essential nutrients from a well balanced diet. There are no scientific grounds at present to support the anti-cancer benefits of taking vitamin or antioxidant supplements. "Besides the risk of toxicity from vitamin mega doses, there is the added danger," notes one University of Toronto expert, "that people who take supplements may falsely believe they are eating well, yet fail to achieve the health benefits of a balanced diet."
 

The epidemiological evidence for anticancer effects from evidence for its dietary precursor, beta-carotene) comes almost exclusively from the comparison of cancer patients with healthy people.  There is literally no evidence for a protective effect of other vitamins, with the exception of a possible association between the intake of vitamins C and E and reduced rates of gastric cancer.

Conclusion

In 1982 the National Research Council, an arm of the U.S.  National Academy of Sciences, issued provisional guidelines intended to reduce the risk of cancer related to food.  The main recommendations were to lower the intake of fat from the current U.S. average of 40 percent of total calories to 30 percent; to eat more fiber, fruits and vegetables; to increase the consumption of complex carbohydrates (such as the starch in flour and potatoes), and to decrease the consumption of pickled, salted or smoked foods as well as of simple carbohydrates (such as
refined sugar).
 

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2. "Diet and cancer", Scientific American, Nov 1987 v257 p42(7), Cohen, Leonard A.

3. "Mystery - and maybe danger - in the air: a government review heightens concern about hazards of the electronic age. (health effects of electricity)" Elmer-Dewitt, Philip, Time, Dec 24, 1990 v136 n27 p67(2

4. "Plant foods, animal foods, and colon cancer."  (Research Report), Potter, J.D. Cancer Researcher Weekly, Dec 27, 1993 p18(3)

5. "The diet-cancer story. (includes related information on dietary influences and cancer risk)", Health News, April 1994 v12 n2 p6(2)

6. The Causes of Cancer, Richard Doll and Richard Peto, Oxford Medical Publications