Transcript Slide 1

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*
Lung & bronchus
31%
Colon & rectum
10%
Men
291,270
Women
273,560
26% Lung & bronchus
15% Breast
Prostate
9%
10% Colon & rectum
Pancreas
6%
 6% Pancreas
Leukemia
4%
 6% Ovary
Liver & intrahepatic 4%
bile duct
 4% Leukemia
Esophagus
4%
 3% Non-Hodgkin
lymphoma
Non-Hodgkin
lymphoma
3%
 3% Uterine corpus
Urinary bladder
3%
Kidney
3%
All other sites
23%
 2% Multiple myeloma
ONS=Other nervous system.
Source: American Cancer Society, 2006.
 2% Brain/ONS
23%
All other sites
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
Prostate
200
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
0
1975
Non-Hodgkin lymphoma
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
suppressor
Li-Fraumeni Syndrome
cell cycle
regulation,
apoptosis
brain tumors,
sarcomas,
leukemia, breast
cancer
APC
tumor suppressor
Familial Adenomatous
Polyposis
signaling through
adhesion
molecules to
nucleus
colon cancer
BRCA1
tumor suppressor
Familial Breast Cancer
repair of double
strand breaks by
association with
Rad51 protein
breast and ovarian
cancer
MSH2 and MLH1
tumor suppressors
Hereditary Nonpolyposis
Colorectal Cancer type 1
(HNPCC1)
DNA mismatch
repair
colorectal cancer
RET protooncogene
Multiple Endocrine
Neoplasia Type 2
transmembrane
receptor tyrosine
kinase for glialderived
neurotrophic
factor (GDNF)
medullary thyroid
cancer, type 2A
pheochromocytoma
, mucosal hartoma
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.

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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.

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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

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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.

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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.
2.
3.
Pershagen G N Engl J Med. 1994 Jan 20;330(3):159-64. Residential radon
exposure and lung cancer in Sweden.
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.
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;15:61731. 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;58:236371.
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-6phenylimidazo[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-1methyl-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

1.
2.
3.
RESULT: Higher rates of Colon Cancer
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.
Kitahara M, et al. Microbiol Immunol. 2001;45(3):263-6. PCR detection method of
Clostridium scindens and C. hiranonis in human fecal samples.
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 Seventhday 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 folatefortified 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.
2.
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.
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 casecontrol 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.
2.
3.
4.
National Health and Medical Research Council (NHMRC) (2001). Australian Alcohol
Guidelines: Health Risks and Benefits. NHMRC, Canberra.
Alcohol in Australia: Issues and Strategies. (2001) Commonwealth Department of Health
and Aged Care, Canberra.
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.
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
Oral Cavity
Nasal Cavities
Larynx
Pharynx
Esophagus
Stomach
Liver







Pancreas
Kidney
Bladder
Uterine
Cervix
Colon
Myeloid Leukemia
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 SepOct;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 7dehydrocholesterol in the dermis to 25hydroxycholecalciferol 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 1525% 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.