Medicine for people seeking holistic alternatives

Intravenous methods may be needed to attain a therapeutic benefit

In Part 1 of this article, we delved into the history of vitamin C use in cancer care. We noted that at least six clinical studies had reported a survival benefit for patients with advanced cancers who received a combination of intravenous and oral vitamin C. Many of these patients also noted significant improvements in their energy levels, pain reduction, appetite, and other measures of quality of life. Unfortunately, no controlled clinical trials have ever been conducted to specifically test the benefits of the IV vitamin C protocol that had been used in the six successful studies.

The original protocol recommended by Dr. Linus Pauling and his Scottish colleague Ewan Cameron, MD, involved a 10-day course of IV vitamin C in which the vitamin was given as a slow-drip infusion of 10 grams sodium ascorbate. After this, vitamin C was given orally in the form of a syrup, at a dose of 2.5 grams every 6 hours for a total dose of 10 grams per day. This strategy enables patients to avoid the diarrhea that otherwise accompanies vitamin C doses in excess of 6 to 7 grams per day. Subsequent studies used oral and intravenous doses ranging from10 to 30 grams per day.

Since Pauling’s day, the recommended dose for IV vitamin C has steadily increased, and some physicians have observed some striking benefits. In the March 2008 issue of Puerto Rico Health Sciences Journal, researchers reported that, “only by intravenous administration, the necessary [vitamin C] levels to kill cancer cells are reached in both plasma and urine.” By giving the vitamin intravenously, one can readily achieve the blood levels (at least 20 mM) that have been reported to selectively kill tumor cells. In at least two clinical trials now in progress, scientists are trying to determine the safety, tolerability, best therapeutic dose, and other key aspects of using IV vitamin C.

Mainstream medical journals have documented the power and potential of this approach. In March 2006, the Canadian journal CMAJ (Canadian Medical Association Journal) told the story of three patients with advanced cancer who had received IV vitamin C. One was a 49-year-old man with “terminal” bladder cancer who had declined chemotherapy. Nine years after receiving the deadly prognosis, he was still alive and apparently free of cancer.

Another patient, a 66-year-old woman, had an aggressive lymphoma with an extremely poor prognosis. After IV vitamin C, her disease went into remission and she was alive and well 10 years later. In a third case, IV vitamin C was given to a 51-year-old woman with kidney cancer that spread to her lungs. Two years later, she had a normal chest X-ray, and a pathologist confirmed the findings.

Why did these patients succeed where others have not? It could be that the secret is in the dosage. Only two controlled clinical trials of vitamin C have been done, and both used oral vitamin C rather than the IV route. But oral doses can never achieve the high blood levels provided by IV methods, the levels necessary for killing cancer.

Reporting in the Proceedings of the National Academy of Sciences, Dr. Mark Levine of the National Institutes of Health has presented new evidence that taking vitamin C intravenously is necessary for achieving the desired blood levels. In five out of nine different cancer lines, Levine’s team found a 50% decrease in cell survival (with lymphoma cells being killed 100%), while normal cells were unaffected. The effective dose was around four millimoles, a concentration much higher than an oral dose but easily achievable with IV vitamin C.

Why is an intravenous infusion more likely to succeed than the oral method? Evidently, when you take vitamin C by mouth, your kidneys will get rid of vitamin C as fast as your gut can absorb it. With the IV approach, blood levels of the vitamin are immediately elevated, and it takes much more time for the kidneys to eliminate the excess. Thus, for a prolonged period, you’re able to expose cancer cells in your body to the levels that may ultimately make a difference.

Dr. Levine also confirmed that vitamin C is metabolized to hydrogen peroxide. Unlike normal cells, cancer cells lack the internal defenses to protect themselves from this highly unstable compound. As a result, they die. (Many chemotherapy agents operate, in part, through a similar mechanism. Green tea, resveratrol, and artemisinin may have similar effects; taken in combination, these natural agents may reach levels of peroxide lethal to malignant tumors.)

These days, IV vitamin C doses may range from 10 grams to as high as 300 grams per day (300,000 mg!), though most doses are in the range of 30 to 80 grams per day. The most widely used strategy is the one created by Dr. Hugh Riordan, a former colleague of Pauling’s and founder of the Center for the Improvement of Human Functioning in Wichita, Kansas. In addition to vitamin C, the protocol includes certain other nutrients, such as alpha lipoic acid. Most clinics charge between $100 and $150 per treatment.

If you have cancer, talk to a nutrition-savvy physician about IV vitamin C. Preliminary reports from a clinical trial in Kansas City indicate that giving IV vitamin C prior to chemotherapy can dramatically reduce the toxicity of those treatments while bolstering the tumor-killing impact of the chemo. Dr. Levine’s most recent clinical report, published in the June 25th issue of the Annals of Oncology, suggests that the combination of chemotherapy or other therapies with IV vitamin C may be critical to achieving therapeutic success in advanced cancer cases.


Sources:

Duconge J, Miranda-Massari JR, Gonzalez MJ, Jackson JA, Warnock W, Riordan NH. Pharmacokinetics of vitamin C: insights into the oral and intravenous administration of ascorbate. P R Health Sci J. 2008;27(1):7-19.

González MJ, Miranda-Massari JR, Mora EM, Guzmán A, Riordan NH, Riordan HD, Casciari JJ, Jackson JA, Román-Franco A. Orthomolecular oncology review: ascorbic acid and cancer 25 years later. Integr Cancer Ther. 2005;4(1):32-44.

Riordan HD, Riordan NH, Jackson JA, Casciari JJ, Hunninghake R, González MJ, Mora EM, Miranda-Massari JR, Rosario N, Rivera A. Intravenous vitamin C as a chemotherapy agent: a report on clinical cases. P R Health Sci J. 2004;23(2):115-8.

Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M. Intravenously administered vitamin C as cancer therapy: three cases.CMAJ. 2006;174(7):937-42.

Chen Q, Espey MG, Sun AY, et al. Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo. Proc Natl Acad Sci U S A. 2007;104(21):8749-54.

Hoffer LJ, Levine M, Assouline S, et al. Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Ann Oncol. 2008 Jun 25.

Was Linus Pauling right about using high-dose vitamin C?

Vitamin C has long been the most widely used dietary supplement, and much of the initial excitement surrounding this vitamin can be traced back to studies conducted in the 1970s by two-time Nobel Prize winner Linus Pauling. A chemist by training, Dr. Pauling had publicly questioned the adequacy of the Recommended Daily Allowance (RDA) for vitamin C, and he suggested that taking gram doses of vitamin C (1000 mg or more) could be effective in the prevention and treatment of colds. At the time, the RDA was a mere 45 mg per day, an amount considered sufficient to prevent scurvy, the classic disease of vitamin C deficiency.

Pauling took the controversy up another notch when he proposed daily doses of 5 to 30 grams for the treatment of advanced cancers. To this day, the very mention of Pauling’s vitamin C research still sparks heated arguments among medical professionals — oncologists in particular.

Clinical studies of the potential therapeutic value of high-dose vitamin C began in Scotland in 1971. The findings from these early investigations were dramatic indeed. Three studies showed a four-fold increase in survival, and one other showed a nearly six-fold increase in survival for patients with advanced cancer. In that last study, 100 patients with “terminal” cancer were compared to 1000 patients who had been given the same bleak prognosis. As with the previous studies, vitamin C was first given intravenously and then orally, in the range of 10 to 30 grams per day. In addition to prolonging survival, many patients receiving vitamin C reported having more energy and a greater overall sense of well-being.

Understandably, these findings attracted much media attention and ignited an explosion of public interest in using vitamin C for cancer therapy. Many thousands of cancer patients began self-prescribing the vitamin. At the same time, however, some scientists sharply criticized Pauling’s research on the grounds that his early studies were not randomized controlled clinical trials, the “gold standard” of medical research. For this reason, the studies’ findings were deemed unreliable or at best preliminary.

Controlled clinical trials are indeed the best way to assess the true value of any proposed treatment strategy. In the case of vitamin C, the ideal study would randomly assign cancer patients to receive either vitamin C or a placebo (a substance having no biological or therapeutic activity), and to do so without the patients knowing which one they were receiving. Researchers from the Mayo Clinic eventually did conduct two randomized clinical trials. Neither trial found a significant survival advantage with vitamin C. Since then, many authorities have cited the Mayo Clinic research as “overwhelming” evidence that vitamin C was not an effective treatment.

But let’s take a closer look at how these clinical trials were done. In the first study, the cancers were too far advanced to reasonably expect any intervention to affect the outcome (average survival for all patients was only 51 days). A more fundamental flaw of both clinical trials was that the researchers provided vitamin C only in oral form. (In Part 2, we show why the oral method is inadequate.) Moreover, the Mayo Clinic team neglected to follow Dr. Pauling’s recommended protocol for achieving “bowel tolerance” — that is, in order to prevent diarrhea, the oral dose was supposed to have been increased gradually over time.

So where do we stand today? One thing we do know is that the jury is still out on vitamin C as a potential cure for cancer. Though a clinical trial is now in progress in Kansas City, no one has adequately tested Pauling’s hypothesis. To date, at least six clinical studies have concluded that high-dose vitamin C did increase survival in patients with advanced cancers. But to achieve the doses that have a therapeutic impact, it seems necessary to use the intravenous method. In Part 2, we’ll talk about some of the most recent reports concerning vitamin C as cancer therapy, and why, in particular, the intravenous approach may be one of the keys to success.

Over the past two decades, laboratory studies have shown that green tea displays a remarkable ability to kill cancer cells selectively, leaving normal cells unscathed. Humans who harbor malignant cells in their bodies may stand to benefit from the tea’s obvious antipathy for cancer. Indeed, in the right dosage range and combined with the right treatment protocol, green tea could play a profound role in the prevention and treatment of many types of malignant disease, notably cancers of the breast, ovaries, prostate, colon and lungs.

As noted in Part I, green tea not only helps keep cancer in check but may enhance the effectiveness of many anti-cancer drugs. For example, the tea seems to improve the therapeutic potential of tamoxifen against breast cancer recurrence. Given that a 5-year course of tamoxifen may entail serious side effects (including blood clots, stroke, endometrial cancer, and endometriosis), it seems sensible to combine an anti-cancer agent like green tea with this anti-estrogen drug. By enhancing the impact of tamoxifen, a green tea supplement (along with other integrative cancer care strategies) could enable breast cancer survivors to shorten the standard period of tamoxifen treatment.

Consumer interest in the tea’s potential health benefits has led to the production of green tea extracts in multivitamins and pure green tea extract. The latter form ensures that the body will receive a fairly high dose of the tea’s most active ingredients, the catechins, of which epigallocatechin-3-gallate (EGCG) is deemed to be the most important. EGCG has been extensively studied for its ability to knock out cancer cells and limit the invasion and metastasis of cancer as well.

Why not just drink green tea? There are several reasons. First, the process of decaffeinating green tea reduces the EGCG content, and green tea supplements are typically free caffeine. Second, green tea supplements can provide the EGCG equivalent of 10 to 12 cups of green tea per capsule. Thus, you can get a sizeable dose of EGCG without having to run to the toilet throughout the day. Many supplements are now standardized to the EGCG content. Try to find a green tea extract that’s standardized to provide not less than 98% polyphenols of which at least 50% should be EGCG.

Is green tea safe to take at high doses? Some individual case reports suggested that green tea, at very high doses, could be toxic to the liver, especially in people who had pre-existing liver diseases. Nonetheless, a recent review of the evidence in the May 14, 2008 issue of Liver International concludes that this is not the case: “An increased consumption of green tea may reduce the risk of liver disease.” Some research indicates, moreover, that green tea limits the liver-damaging impact of drugs such as tamoxifen.

Even so, at the present time, there are no well-designed human studies on the toxicity of green tea supplements. Animal studies have shown that high doses of the EGCG can cause liver, kidney, and gastrointestinal toxicities. And anecdotal reports of toxic effects in humans are beginning to emerge: To date, there have been nine case reports of liver toxicity in humans linked with consuming high doses of green tea from dietary supplements.

At the present time, there is no established “upper tolerable limit” for green tea intake on a daily basis. Rutgers chemical biology professor Chung Yang, a leading authority on green tea’s anti-cancer effects, suspects that some individuals with liver diseases such as hepatitis or cirrhosis may be at greater risk of toxic side effects if they ingest too much green tea. When a person’s liver is already under stress, the toxic effects may become amplified. On the other hand, it seems clear that low or moderate amounts of green tea will have protective effect against both liver toxicity and cancer—once again supporting the adage, “Everything in moderation. Nothing to excess.”

As to which dose of green tea is optimal for daily use, no one really knows. Green tea supplementation is a relatively recent phenomenon, and there is no solid research upon which to lay down firm guidelines. Most green tea supplements provide 100 to 500 mg of green tea concentrate per capsule. The lower doses are sometimes available in the form of a phytosome, a specific preparation (phospholipid complex) of green tea that has been shown to provide better absorption. This is important, since green tea polyphenols are poorly absorbed into the bloodstream. In principle, 100 mg of the phytosome form may provide as much green tea as 500 mg of the non-phytosome form; however, more research is needed to determine whether this is actually the case.

One advantage to using a lower dose of green tea (say, under 300 mg per day)is that it may lower one’s risk of promoting anemia. This is the most likely side effect of taking daily doses in excess of 500 mg for long periods of time. Yang and other green tea experts contend that taking no more than 500 mg per day is generally safe; moreover, taking larger daily amounts but spreading the dose out over the course of the day will substantially lower the risk of toxic side effects. Thus, taking 500 mg (or 100 mg of the phytosome form) two to three times a day may be acceptable for most people, at least for short periods of time and as long as no serious liver disease is present.

Until the necessary studies are done to define the safe upper limit for green tea supplementation, however, it is best to consult with a nutrition-savvy health professional who has a clear understanding of your particular condition and biochemical needs, based on your personal health and dietary histories. Working with a professional who understands the art and science of supplementation is also important. For example, to help stave off prostate cancer relapses, it may be helpful to combine green tea with lycopene, vitamin E, selenium, vitamin D, and soy protein. The combined effect of these natural products should enable one to lower the dose of green tea while still providing the protective benefits.


Sources:

Jin X, Zheng RH, Li YM. Green tea consumption and liver disease: a systematic review. Liver International. 2008 May 14

Mead MN. Temperance in green tea. Environmental Health Perspectives 2007;115(9): A445.

Lambert JD, Sang S, Lu AY, Yang CS. Metabolism of dietary polyphenols and possible interactions with drugs. Curr Drug Metab. 2007 Jun;8(5):499-50

Tea ranks second only to water as a beverage worldwide and has been considered to have health-promoting properties since ancient times. In many Asian cultures, green tea is still a dietary staple and may also be found in gum, breads, candy, ice cream, and desserts. Here in the US, bottled, flavored green tea “drinks” and instant green teas are increasingly common. It turns out, however, that these commercial preparations have very low levels of green tea polyphenols, the components that are thought to account for most of the tea’s health-related impact.

Many human population studies have linked higher tea consumption with a lower incidence of cancer, cardiovascular disease, and neurodegenerative disorders. In terms of cancer prevention and treatment, we know from numerous laboratory studies that green tea can selectively kill cancer cells (leaving normal, healthy cells untouched). What follows is a sampling of some of the most recent reports on green tea’s role in warding off cancer:

• A May 21, 2008 report in the medical journal, Cancer Letters, states that “Green tea is a nature’s gift molecule endowed with anticancer effects…Clinical trials of green tea polyphenols, especially in prostate cancer patients, have yielded encouraging results.” The authors go on to state that green tea may be used as part of “multitargeted therapy” for several cancers.

• A report in the April 4, 2008 issue of European Urology concludes that green tea supplementation “led to an almost 80% reduction in prostate cancer diagnosis,” effectively preventing the progression from high-grade PIN (the main premalignant lesion) to prostate cancer. Two years earlier, the same research team reported in Cancer Research that “that up to 90% of chemoprevention efficacy” could be obtained by green tea supplementation by men at high risk of developing prostate cancer. The next step will be to determine whether green tea can also help prevent relapses of prostate cancer.

• A number of studies have suggested that green tea may enhance the effectiveness of tamoxifen for women with breast cancer and moreover eliminates resistance to tamoxifen treatment. Researchers from the University of California’s Center for Human Nutrition recently reported that the combination of green and tamoxifen was more potent than either agent alone at triggering “cell suicide” (apoptosis) in breast cancer cells.

• A systematic review of the evidence on green tea and breast cancer recurrence was recently reported in the June 2005 issue of Integrative Cancer Therapies. When considering cohort studies, the researchers found a 25 percent reduction in the risk of breast cancer recurrences, though this was not statistically significant. On the other hand, when only stage I and II breast cancers were considered, there was a 46 percent reduction in the risk of breast cancer, and the finding did reach statistical significance.

As you can see, the anti-cancer potential of supplementing with green tea is nothing to sneeze at. For survivors of most types of cancer, finding safe, practical, and effective ways to stave off recurrences is of utmost importance. If green tea is indeed safe and shows this cancer-curbing potential, then its use deserves serious consideration — even if the best available evidence does not include randomized controlled trials, the “gold standard” of clinical medicine. In Part II of this article, we’ll consider some of the more practical issues around the use of green tea supplements.


Sources:

Khan N, Mukhtar H. Multitargeted therapy of cancer by green tea polyphenols. Cancer Lett. 2008 May 21.

Brausi M, Rizzi F, Bettuzzi S. Chemoprevention of Human Prostate Cancer by Green Tea Catechins: Two Years Later. A Follow-up Update. Eur Urol. 2008 Apr 4.

Bettuzzi S, Brausi M, Rizzi F, Castagnetti G, Peracchia G, Corti A. Chemoprevention of human prostate cancer by oral administration of green tea catechins in volunteers with high-grade prostate intraepithelial neoplasia: a preliminary report from a one-year proof-of-principle study. Cancer Res. 2006 Jan 15;66(2):1234-40.

Sartippour MR, Pietras R, Marquez-Garban DC, Chen HW, Heber D, Henning SM, Sartippour G, Zhang L, Lu M, Weinberg O, Rao JY, Brooks MN. The combination of green tea and tamoxifen is effective against breast cancer. Carcinogenesis. 2006 Dec;27(12):2424-33.

Seely D, Mills EJ, Wu P, Verma S, Guyatt GH. The effects of green tea consumption on incidence of breast cancer and recurrence of breast cancer: a systematic review and meta-analysis. Integr Cancer Ther. 2005 Jun;4(2):144-55

The chemotherapy drugs, Taxol (paclitaxel) and Taxotere (docetaxel), can have a powerful impact on survival for many people with advanced metastatic cancers. But these drugs can also incur damage to the sensory nervous system, resulting in the condition known as peripheral neuropathy, a painful tingling or numbness in the feet and hands. So uncomfortable and stressful are these symptoms that oncologists are often compelled to reduce the dosage, thus limiting the tumor-killing potential of the treatment. One strategy that is being used with some success is the antioxidant supplement called alpha-lipoic acid, or ALA.

A number of studies have found that ALA may be effective in treating the peripheral neuropathy that afflicts people with diabetes. The supplement is referred to as the “mother of all antioxidants” because it tends to support the activities of vitamins C and E, and other antioxidants. Since free radicals are thought to be a major part of the mechanism behind the nerve damage, it makes sense that ALA might have some protective effect. The nerve-protecting benefits of ALA for diabetics seem so convincing that some oncologists have begun recommending the supplement to cancer patients.

In a 2003 issue of Annals of Oncology, researchers at the University of Vienna (Austria) presented the first-ever study of cancer patients receiving ALA to counteract the neurotoxic effects of chemotherapy drugs. Fourteen people were enrolled in the study, including six with lung cancer, five with advanced gastric cancers, and three with head and neck tumors. The neurotoxic or nerve-damaging drugs included Taxotere and Cisplatin.

Each of these patients had reported experiencing numbness or tingling in either their hands or feet or both, and also had reported a burning sensation after receiving the chemotherapy. All 14 patients received 600 milligrams of ALA intravenously once a week for three to five weeks. This was followed by 1800 milligrams orally (600 mg three times a day) until they recovered fully from the neuropathy. Each patient took ALA for a maximum of six months.

The study’s findings seemed to support the use of this antioxidant supplement. Eight out of the fourteen patients (57%) showed a favorable response to ALA. In six patients with moderate or grade 2 nerve damage, treatment with ALA resulted in a major improvement in neurological symptoms. In two patients who suffered from severe or grade 3 nerve damage, ALA supplementation brought substantial relief of symptoms. Some patients responded rapidly to ALA (within three weeks), while others took two to three months to respond.

These findings indicate that ALA, when used to counteract chemotherapy-related neuropathy, may be able to stop and reverse the nerve-damaging effects of the anticancer drugs. No major side effects were reported from taking the ALA. In other research, ALA has shown some direct anticancer activities as well. Given the wide margin of safety for this supplement, ALA may indeed be considered a promising way to protect the nervous system during chemotherapy.

One concern voiced by many oncologists regarding the use of antioxidants is that these supplements may interfere with chemotherapy. Nonetheless, this concern appears to be unfounded, at least based on a recent systematic review of the 19 randomized controlled trials published thus far. Reporting in the August 2007 issue of Cancer Treatment Reviews, researchers concluded that antioxidant supplements taken concurrently with chemotherapy treatments do not appear to diminish the effectiveness of those treatments. Though more clinical research is needed, the evidence to date suggests that antioxidants may help improve tolerance to chemotherapy without reducing its therapeutic impact.

Sources
Gedlicka C, Kornek GV, Schmid K, Scheithauer W. Amelioration of docetaxel/cisplatin induced polyneuropathy by alpha-lipoic acid. Ann Oncol. 2003; 14(2):339-40.

Ziegler D, Hanefeld MH, Ruhnau KJ et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant -lipoic acid. A 7-month multicenter randomized controlled trial (ALADIN III Study). Diabetes Care 1999; 22: 1296-1301

Rock E, Demark A. Nutritional approaches to late toxicities of adjuvant chemotherapy in breast cancer survivors. J. Nutr., November 1, 2003; 133(11): 3785S - 3793

Block KI, Koch AC, Mead MN, Tothy PK, Newman RA, Gyllenhaal C. Impact of antioxidant supplementation on chemotherapeutic efficacy: a systematic review of the evidence from randomized controlled trials. Cancer Treat Rev. 2007 Aug;33(5):407-18

In Part 1 of this series, we explored the importance of being physically and mentally fit for cancer treatment. One might well ask, Why do health professionals often overlook the importance of exercising and getting in shape after a cancer diagnosis? Several reasons may be highlighted. To begin with, it was long assumed that getting more bed rest was the right thing to do after the diagnosis. Cancer patients were advised to take it easy and nap as much as possible. Doctors and nurses routinely told their patients that exercise tended to deplete energy while bed rest helped conserve energy.

That belief now seems to be radically incorrect. Recent research by Dr. Maryl Winningham and others suggests that too much rest steadily depletes one’s energy levels and further exacerbates fatigue. According to Winningham’s studies, staying in bed or sitting around watching TV after a cancer diagnosis sets up a vicious cycle. Blood circulation stagnates and this results in a poorer distribution of oxygen and other nutrients throughout the body. Because oxygen and nutrients are needed to support healthy (aerobic) metabolism, the result of this stagnation is diminished energy and increasing fatigue over time, thus further amplifying the desire to remain inactive. As the downward spiral continues, the fatigue and inertia become so extreme that the mere thought of exerting oneself seems like a Herculean endeavor.

Ironically, then, the antidote to this problem is movement itself. By boosting your heart rate with regular, low-impact, aerobic exercise, you greatly increase your capacity to perform the activities of daily living and improve your overall quality of life. You also enhance the functioning of your liver and lymphatic and circulatory systems, all of which tends to further bolster your personal well-being.

Another major reason to engage your muscles after a cancer diagnosis is to help prevent the process of physical wasting that affects many individuals with advanced-stage cancers. Cancer shifts the body’s metabolism into a “breakdown” or catabolic mode, thus further increasing the muscle-degrading effects of not exercising. The loss of muscle leads to less aerobic activity, reduced endurance, and yet more immobility-another vicious cycle. The solution is to engage in gentle workouts with small weights as well as mindful, continuous weight-bearing exercise such as Tai Chi to help build and maintain the large muscles of the legs.

Remember that overly strenuous exercise can damage tissue and may actually increase inflammation. It is ill-advised for anyone who feels out of shape to push their bodies in a strenuous way, especially if they have just gone through major surgery, chemotherapy, or other intensive treatments. Restorative yoga, Qigong, or the use of a TheraBand can all be immensely healing and therapeutic.

Equally helpful, according to some experts, is the targeted use of nutritional pharmacology to control the lean-tissue wasting process known as cachexia. This is a chronic low-grade inflammatory imbalance that keeps your muscles in breakdown mode. According to cachexia expert Vickie Baracos of the University of Alberta, in Edmonton, Canada, a combination of resistance exercise, omega-3s, high-quality protein and anti-inflammatories may be the key to reversing this deadly problem. We will explore such strategies in future blog installments.

Cancer patients and cancer survivors may greatly benefit by increasing their level of physical activity and adopting a healthier, plant-based diet.

People diagnosed with cancer rarely ask their oncologist whether or not they have the physical and mental “fitness” to undergo treatment. And yet, this is an entirely relevant concern. The rigors of cancer therapy are often so taxing that about one in every three individuals who undergo chemotherapy end up quitting before they have a chance to complete their treatments.

Clearly one needs to be in good physical condition when receiving conventional cancer therapies, and yet research suggests that many patients are unfit when they come in for treatment. A study published in the April 21, 2008 issue of the prestigious journal Cancer concluded that far too many cancer patients are overweight and out of shape. Researchers at the University of Alberta in Edmonton, Canada, analyzed data from more than 114,000 adults. They found that one in three cancer survivors was overweight, while nearly one in five was obese. Moreover, fewer than 22 percent of all cancer survivors were physically active.

Of even greater concern was the finding that obese breast cancer survivors were less active compared with obese women who did not have a cancer history. The concern here is that obesity increases the risk of recurrence and mortality after a breast cancer diagnosis. Obese breast cancer survivors who exercise more not only may keep the disease from recurring but can also greatly improve their quality of life during and after cancer treatment. They feel better, sleep better, and have more stable moods and energy levels overall.

Another aspect of getting physically fit after a cancer diagnosis has to do with better handling the side effects of conventional cancer treatments. Intensive chemotherapy and radiotherapy can take a heavy toll on mind and body. Malnutrition, anemia (often accompanied by chronic fatigue), dehydration, infection, fever, reduced white blood cell counts are among the more common side effects that force many patients to visit the emergency rooms. For each month of chemotherapy, the chance of experiencing a major side effect increases by 20%. No small wonder, then, that so many patients end up prematurely dropping out of treatment.

Here, too, the logical solution is to take better care of oneself and get in shape. Just as you want to be nutritionally, physically and psychologically fit to undergo surgery, you want to be fit enough to handle the effects of intensive tumor-killing treatments. You want to do everything possible to maintain a stronger, healthier body. If you feel that you need guidance, seek out a nutritional oncologist and exercise physiologist, or look for a cancer rehabilitation program in your area.

Recent research has shown that about half of all patients improve their dietary habits and quit smoking after a cancer diagnosis. But one out of every three either stops exercising or exercises less frequently than before the diagnosis. In one study, most patients reported having exercised prior to their diagnoses, and yet fewer than half of those same individuals kept up an exercise routine after the diagnosis. Again, overweight individuals, and those receiving both radiotherapy and chemotherapy, were least likely to resume an exercise regimen.

Around the country, cancer rehab programs are beginning to spring up to help patients get in shape before, during and after their treatments. Integrative medicine clinics are offering cancer rehab programs that include whole-body fitness training and specific nutritional strategies to offset treatment-related side effects. The best programs also provide psychological support and counseling as well. Though this integrated approach, many side effects can be greatly minimized and in some cases avoided altogether. And because nutrition and exercise are among the controllable risk factors for preventing a cancer recurrence, there’s a better chance of staying in remission after participating in such a program.

In Part 2 of this article, we’ll address some of the myths that pertain to getting fit after a cancer diagnosis.

For decades we’ve known that the people living in France have among the lowest incidences of coronary heart disease in the Western world. What’s surprising is the fact that the typical French diet is relatively high in fat. This phenomenon, known as the French paradox, has long puzzled heart disease experts worldwide, and many have pointed to the high consumption of red wine in France as the main protective factor. In Part 1 of this series, however, we began to explore some equally strong explanations for the French paradox, with a focus on the 40-country study by Drs. William and Sonja Connor in the 1990s.

The Connors’ research unveiled another major dietary difference between the French and Fins: per capita consumption of vegetables was four times higher in France than in Finland. The French also ingested eight times more vegetables oils and thirty times more olives. Other research has confirmed that diets high in cereals, legumes, vegetables and vegetable oils help keep the coronary arteries from clogging up. (Perhaps just as important, we also know that the French eat smaller portions and take longer to eat their meals compared to their U.S. counterparts.)

By no means do these findings detract from the protective effects of red wine. But red wine is only one of many dietary pieces to the healthy heart puzzle. In the July 2007 issue of the European Heart Journal, researchers note that the beneficial or cardioprotective effects of red wine have mostly to do with their polyphenol content. These grape compounds, notably resveratrol, have been shown to reduce levels of oxidized LDL, dilate blood vessels, lower blood pressure, render the blood less “sticky” (via platelet de-aggregation), alter the liver’s metabolism of cholesterol, reduce inflammation, and protect the arteries and heart muscle. Red wine seems to confer its strongest heart-friendly effects in the context of a high-fat diet—so it seems wine and cheese really do go well together after all.

The Connors’ research helps illustrate the complexity of dietary factors involved in heart disease. When it comes to assessing the risks of dying from heart disease, no one nutrient or food can be singled out. Instead, one has to consider the total diet. Another classic example of how this bears out concerns the Eskimos, for whom cardiovascular disease is virtually absent, despite a diet very high in fat and cholesterol. The discrepancy most likely has to do with the fact that Eskimos traditionally get most of their fat from marine sources, namely seal, whale, and fish. These sources provide large quantities of the “good” omega-3 fatty acids, which confer numerous heart-friendly effects.

The take-home message: Vegetables, omega-3 fatty acids, and light or moderate consumption of red wine can be very good for your heart, particularly if you’re also getting regular exercise (gentle aerobics and resistance training) and getting a reprieve from the high-pressure arena of life through rest and relaxation. Eating some fat on the side is not going to kill you, though anyone with high blood lipid levels (in particular, high total cholesterol, LDL, and triglycerides) would do well to lower their fat intake for a few months while striving to get their health back on track. In addition, for many individuals, selective use of supplements such as phytosterols, garlic, resveratrol, guggul, and policosanol may further ensure a heart-friendly advantage.


© 2008, Mark N. Mead and Plum Spring Clinic

The idea that excess dietary fat begets clogged arteries—and eventually heart disease—has long been gospel among nutritionists and health food buffs. Studies of human populations the world over have shown that the more cholesterol and saturated fat people consume, the higher the death rates are due to coronary heart disease (CHD). Back in the early 1990s, Drs. William and Sonja Connor at Oregon Health Sciences University, along with Sabine Artaud-Wild and Gary Sexton, confirmed the fat-coronary connection in 40 countries, all of which had populations exceeding one million. As expected, however, two countries—France and Finland—failed to fit the pattern.

The Finnish-French paradox has puzzled scientists for decades. Of all European countries, Finland has the highest death rate from coronary heart disease, while France has the lowest—at least four times lower than that of Finland. And yet, the average per capita intake of both cholesterol and saturated fat is remarkably similar for the two countries. Scientists and lay people alike have held to the view that red wine is what protects French hearts even with all that cheese on the side. But the Connors suspected that differences in the consumption of other food factors could shed light on the paradox.

Their observations, first published in the December 1993 issue of the journal Circulation, confirmed this intuition. Though meat consumption was similar between the two countries, there were striking differences in the consumption of dairy products and plant foods. Compared to the French, the Fins consume three and one-half times more cow’s milk, butter and cheese. There also appears to be a relationship to milk protein intake, which is twice as high in the Finnish diet compared to the French diet. Previous research had shown that casein, a protein in cow’s milk, produced high cholesterol levels in animals.

The dairy connection is one reason we recommend substituting soy products for dairy products when your blood lipid levels are off kilter—for example, when you have a high total cholesterol, as well as high LDL and triglyceride levels. Though soy itself has only a very weak effect on cholesterol levels, consuming it in lieu of fatty dairy products (butter, cheese, and ice cream) while help improve your blood lipid levels. We also recommend consuming more nuts and seeds, and substituting fish for poultry and red meats as much as possible.

In Part 2 of this series, we’ll explore the other factors that are most likely to explain the French Paradox. As you will see, it’s important to think beyond the simplistic wine-and-cheese terms that have tended to dominate the debate since its inception.

Vegetables are among the only foods you can eat to your heart’s content without gaining weight and promoting illness.  That’s because, on a per-calorie basis, vegetables really pack in the nutrients you need for good health.  A mere half cup of broccoli, for example, provides 60 to 70 milligrams of vitamin C, which the body needs to neutralize harmful free radicals and keep cancer cells from turning into deadly tumors.  At the same time, brightly colored vegetables contain hundreds of different carotenoids, flavonoids, and other so-called phytochemicals, many of which have potent anti-cancer and health-promoting properties.

A half cup of even the most starchy vegetables—potatoes and squash, for instance—provides no more than 100 calories.  That’s less than the calories in a tablespoon of butter or oil.  Indeed, the butter or cream sauce you may have added in the past has many times the calories of vegetables.  The good news is that, with vegetables, it’s okay to eat all you can eat.  If you make them the core of your daily diet, your body will thank you for years to come.

Many people are getting sick these days because they’re not eating enough fresh vegetables.  Huge losses of nutrients result from milling, storage, shipping and overcooking.  For instance, spinach, lettuce and other greens suffer more than a 30 percent loss of vitamin C due to temperature changes, air movement and humidity.  Vitamins A, E and C are especially vulnerable to oxidation during storage; the loss of vitamin E due to this oxidation process may be 50 percent or more.  Vitamin E loss in freezing may be as high as 50 percent as well, and thawing of frozen foods may result in further losses.  The take-home lesson is this: eat your vegetables, but keep them as fresh and unprocessed as possible!

If you’re looking for ways to determine which vegetables will pack in the best nutritional value for your money, then consider their color.  In general, the deeper or darker the vegetable, the better its nutritional value.  Pale, small carrots, for example, have several times less vitamin A than mature, bright-orange carrots.   Dark-green leafy vegetables are, for the most part, a great deal higher in nutrients than light greens, such as iceberg lettuce.  And if it’s vitamin A you seek, go for deep-orange vegetables like carrots or winter squash.

Though these tips don’t guarantee an optimal diet, they’ll at least point you in a healthier direction.  The mix of vegetable colors also serves as a kind of positive reinforcement, since it makes your meal a feast for the eyes as well as the belly.  Adding color to your dietary plan is just one more incentive to eat well.