Does Nutrition Matter? - Desert Cancer Foundation of Arizona
Does Nutrition Matter? E. Hernandez M.D., M.S., F.A.C.S. And Heather Paulson, ND, FABNO Desert Cancer Foundation of AZ October 25, 2012 Aromatase Inhibitor (Anastrazole) Phytochemical Flavones (white mushroom, Aganicus Bisporus) 1.) Used in postmenopausal women with breast cancer to block conversion of androgen to estrogen at the adipose cellular level. 2.) Body Builders use anabolic steroids which result in gynecomastia. Using anaztrazole or white mushroom may lower estrogen. Aromatase Inhibitor-Anastrazole, and white mushrooms Natural Statins Sources statins increase HDL, and lower LDL Oyster Mushrooms Soybeans Brussel Sprouts Yams Sesame Oil Statins & P53 Mutant (Crestor, Lipitor) -P53 Mutant: Thought to be found in approximately 30% of women diagnosed with breast cancer. - Causes disorganized growth of cells to atypia, than neoplasm. - Current ongoing studies on Statins and P53 in Norway, Great Britain, Japan, Australia, USA at Columbia University. Theory out of Norway Breast cancer cells taken from women diagnosed with breast cancer who test positive for P53. Statins thought to interfere with sterol biosynthesis in tumor cells at mevalonate level. MEVALONATE KINASE Danish Statin Study Ongoing study: 17,000 women with breast cancer & associated P53. Treated with statins had a 17% decrease in recurrence. Since we know that about 30% of women with breast cancer test positive for P53, should we not treat these patients with statins & hope for decrease in invasive growth? Study cautiously says yes. Associated Clinical Studies: Men treated with statins also report having a lesser chance of developing prostate cancer. This is also a theory. Associated treatment with HDL (oils) and Pesco Vegan consumption- almost zero saturated fat. WINS- Women’s Intervention Nutritional Study With early diagnosed breast cancer & treated with conventional treatments 2006 study-2400 women treated with low fat 30-50 grams of fat- pesco vegan (fish, shellfish, vegetables, no dairy products) Half of total number had no restrictions of diet. After 5 years, recurrence was 7.8% compared to 12.8%. ER/PR positive group had better outcome. Theory The consumption of Omega 3 Fatty Acids (fish oil) may lower the inflammatory process in fat cells, thereby lowering estrogen production, and therefore lowering the risk of developing breast, rectal and colon cancers The study showed that is mostly closely related to breast cancer It also benefitted the inflammatory process in coronary vessels. In this study there were multiple inclusions and exclusions such as bleeding disorders, renal disorders, and patient’s using oral hypoglycemic agents. Obesity & Vitamin D Natural sources of Vitamin D (cod liver oil, sardines, swiss cheese) Is obesity an inflammatory disorder? Theory: fat cells are now found to have an inflammatory associated factor. Fat cells have associated increase in aromatase. Obese patients also have deficiency in Vit D. Women with higher levels of Vit D were found to have smaller tumors at the time of diagnosis. Higher levels of Vit D in patients with breast cancer had associated longer period between remission and relapse. Theory- Obese patients- fat binds to Vit D Postmenopausal women in general terms have lower levels of Vit D. Vit D deficiency is linked to triple negative breast cancer- an aggressive component. Levels of Vit D can be a predictor of cancer treatment & outcome. High dose Vit D prevents cancer cell growth. Question: Should all obese patients be treated with aromatase inhibitors, antiinflammatory drugs, high dose Vit D, omega 3, oral hypoglycemics, statins and low fat diet- below 50g per day? Question: Should all patients who are post-menopausal and have breast cancer be treated as well? Theory vs Application We must balance benefits, disadvantages, logic, ethics, and show good clinical judgment when treating patients using any theory based on any ongoing studies. I say treat when safe, work with both medical & radiation oncologists, surgeons, and naturopathic colleagues to ultimately cover all needs which these patients deserve. Radiation Therapy – Green Tea Green tea protects against oxidative damage to cells and tissue Shown to increase HDL and decrease LDL Block Perioxidation of LDL to ultimately prevent platelet aggregation Inhibit growth of cancer cells and metastasis Duck: High in protein, and without skin, less calories than chicken. Also a good source of vit A, B3, and C, iron, and selenium. Niacin (B3) helps lower LDL and aids in metabolizing fats. Red Meat High in nutrients zinc, iron, thiamine, and riboflavin. Although higher in saturated fat, cholesterol, and trans fat versus white meat. Chicken Leaner than red meat and high in protein. Although, the skin is high in saturated fat, so remove it prior to eating. Great Foods Lentil beans and grains like quinoa, are also a great source of non-animal protein and fiber. While nuts like almonds and walnuts are full of “good fats” and high in protein. Special thanks to Lee’s Oriental Market and Comedor Guadalajara for helping with this talk. Thank you Alexa Fine. Yes! Nutrition Matters. How To Implement Changes Dr. Heather Paulson The Life Center at Arizona Natural Health Center The Good News: Cancer Risk Can Be Modified with Lifestyle Factors Estimated 50% of common cancer diagnosis could be eliminated Weight Management Obesity is estimated to cause 20% of cancers today Exercise Lack of exercise is associated with 5% of all cancers Diet A poor diet is associated with 5% of all cancers What you already know Exercise 30 minutes a day Eat more vegetables 5 – 9 servings Include 30 grams Drink fiber in your diet health promoting liquids Green tea Matcha Celestial Seaonings 4 – 9 cups a day Water If I know all this, why don’t I do it? Our own health is low on the priority list Too much conflicting information Confused Time management Some Motivation Exercise 3 – 5 hours per week of walking after breast cancer diagnosis reduced risk of death from disease Protective against weight gain and obesity Also studies supporting reduced risk of colon cancer and reduced progression of prostate cancer Weight Loss Excess body weight contributes to as many as 1 out of 5 cancer related deaths! Clearly linked to: Breast, Colon, rectal, endometrial, esophageal, kidney, and pancreatic cancer Waist circumference/belly fat is linked to increased risk of postmenopausal breast cancer Also a marker of insulin resistance It’s Just Fat…why does it matter so much? Fat communicates as part of the endocrine system for hormone management Part of Lipid Metabolism: TGL, HDL C-Reactive Protein = INFLAMMATION Insuslin sensitivity via adiponectin Insulin and Cancer Insulin receptors are on normal cells and cancer cells Increases sex hormone synthesis Creates a low grade inflammatory state stimulating cancer growth factors IL-6, TNF-alpha, cell adhesion molecules, fibrinogen, and C-reactive protein Stimulates Tyrosine Kinase growth factor cascade to promote cancer cell proliferation Improve Insulin Sensitivity Plant based diet High fiber High fish Omega 3 fatty acids Weight lifting Walking Cinnamon Dark Chocolate Raw Cacao highest in polyphenols Vitamin D DS – prostate cancer Initially responding well to hormone blocking injections post prostate radiation Fasting Insulin increases while PSA climbs Started an insulin resistant diet and exercising more regularly Began taking Chromium & Resveratrol, increased Fish Oil. Fasting Insulin normalized and PSA resumed response to injection therapy. How Much Weight? Check your BMI BMI Calculators available online Healthy BMI = 25 Average BMI in US = 27.8 for Males, 28.1 for females Time and Place for Weight Loss Better suited for cancer prevention and survivorship Can be dangerous to implement weight loss programs during treatment, unless advised to do so by your physician. Weight gain after treatment may affect survival of breast cancer Vitamin D Why? How Much? Sources? Vitamin D…how much? Suggested general dosing: Ages 1 – 70: 600 International Units daily 70 and above: 800 IU’s daily Up to 2,000 IU’s daily generally thought of as safe Up to 7,000 IU’s daily did not cause hypercalcemia Dosing changes based on health conditions Fracture prevention: equivalent of 100,000 IU’s once every 3 months Cancer prevention: people taking 1,000 IU’s daily had lower risk of colon cancer Vitamin D…too much of a good thing? Too much vitamin D might increase cancer risk Hormone Can influence breast and prostate cell growth Get your blood levels tested to find out what dose is right for your body. Natural Food Sources of Vit. D Very few foods Egg Yolks Cod Sardines: 1/4th of daily dose/serving Salmon: half a fillet = 1400 IU’s Fortified: milk, OJ, cereal (at most 1/6th of daily dose) Mushrooms: Shitake have highest amount at 45 IU’s per serving Cheese: specifically ricotta, contains 45 IU’s/ Speaking of Mushrooms 100 grams daily = 3.5 ounces daily 24.5 ounces weekly Impact immune system function Beta-galactans Water soluble Natural source of vitamin D Inhibit aromatase enzyme Natural Aromatase Inhibitors Limited human data, clinical trials accruing at City of Hope Red Wine (resveratrol) White button mushrooms Green Tea Black Tea Stinging Nettles Stevia Mangosteen With all the diet information out there, how can I keep it simple? EAT A RAINBOW!!! General fruit and veggie recommendations At least 2.5 cups Each color of fruit/vegetable has it’s own phytochemicals Red = lycopene Orange = beta-carotene Yellow = Quercetin, Vitamin C, Bromelain Green = sulphoraphanes Blue/Purples = bioflavanoids and anthocyanins How to Use Green Tea Topically Taking green tea baths Applying green tea topically during radiation Protects DNA Against UV radiation Internally 4 – 9, 8 oz servings per day. Can reuse teabags To remove caffeine steep for 15 seconds, then discard and resteep Team Work Targeted nutrition, exercise, and supplements are part of a comprehensive prevention and cancer care program Modify your cancer risk factors, become an active member of your own health care team. THANK YOU! DESERT CANCER FOUNDATION DR. HERNANDEZ ALL OF YOU HERE SUPPORTING DCFA
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