My view as I write this!

Yesterday I was flipping through my binder of cancer articles that I have collected, intending to read when I have the chance, and came across this article written by Dr. Steven Nemeroff, Oncology Health Advisor to Life Extension Foundation. Click here for the full article.

I am not a doctor, but I can give a ‘Coles Notes’ version of this article so that you can decide whether or not it contains information you would be interested in researching further and discussing treatment options with your MD, ND and oncologist. Knowledge is power!

As you probably know, the surgical removal of the primary tumor is the first treatment option for many cancers. The reason behind surgically removing the tumor is that once the tumor has been removed, then the body can be returned to health. Unfortunately this approach doesn’t take into account the reality that, in many instances, after surgery the cancer frequently metastasizes (spreads to another organ). This metastasis can be more serious than the original tumor – and can often prove fatal.

Metastasis of the tumor may occur after surgery as a result of cancer cells splitting off from the tumor and dispersing into the bloodstream or seeding directly into the chest or abdomen. To form a new tumor, that cell must first adhere to the lining of the blood vessel where it secretes powerful enzymes that break down the epithelial lining and basement lining of the blood vessel and allow the cell to burrow through the surrounding connective tissue and arrive at the organ that is its final destination. Here the cancer cell can multiply and form a new colony.

Given this information, what can individuals undergoing surgery to removal a tumor do to protect themselves against an increased risk of metastasis?

Cancer cell adhesion

Cancer cells that have broken away from the primary tumor utilize adhesion molecules – called galectin-3 – to adhere to clump together and thereby form colonies. These molecules are present on the surface of cancer cells and work like Velcro to allow free-standing cancer cells to stick together. Galectin-3 is also used by cancer cells circulating in the bloodstream to latch onto the lining of the blood vessels. This adhesion is a critical step in the tumor forming process.

According to Dr. Nemeroff, a natural supplement called modified citrus pectin (MCP) can inhibit cancer cell adhesion by binding to the galectin-3 adhesion molecules on the surface of cancer cells, thereby preventing cancer cells from sticking together and forming a cluster. MCP can also inhibit circulating tumor cells from adhering to blood vessel linings. There’s a lot of research that has been done to determine the efficacy of MCP and it’s available in this article. Most trial dosages have been 14.4 grams/day for one year.

In addition to modified citrus pectin, studies using Cimetidine (common name is Tagamet, an over the counter medication for heartburn) have shown that it inhibits cancer cell adhesion by blocking the expression of an adhesion molecule – called E-selectin – on the surface of cells lining blood vessels. This blocks the ability of cancer cells to latch on to the blood vessel walls.

The combined data suggests that at least five days prior to surgery, to ingest 800 mg of cimetidine daily and at least 14 grams of modified citrus pectin daily. According to Dr. Nemeroff, this regimen can be followed for a year or longer to reduce metastatic risk.

Preventing Surgery-induced Immune Suppression

The immune system plays an essential role in healing cancer. An important white blood cell to be aware of is the Natural Killer cells (NK). It’s role is to seek out and destroy cancer cells. However, surgery itself reduces NK activity! So without question, it is critical to actively strengthen the immune function by enhancing NK cell activity in the period before surgery.

One prominent natural supplement that can increase NK cell activity is PSK, a specially prepared extract from the Coriolus mushroom. Other supplements that have been documented to increase NK cell activity are garlic, glutamine, IP6 (inositol hexaphosphate), AHCC (active hexose correlated compound) and lactoferrin.

Pharmaceuticals used to increase NK cell activity include interferon-alpha and granulocyte-macrophage colony stimulating factor, as well as interleukin.

At least five days prior to surgery, institute a natural killer cell enhancing program involving PSK, lactoferrin, glutamine, garlic, IP6, and AHCC.

Cancer Vaccines

Produced from a person’s own cancer cells removed during surgery, these highly individualized cancer vaccines greatly amplify the ability of the immune system to identify and target any residual cancer cells present in the body. Cancer vaccines provide the immune system with the specific identifying markers of the cancer that can then be used to mount a successful attack against metastatic cancer cells.

Angiogenesis

Angiogenesis is the process by which new blood vessels are formed from pre-existing blood vessels. Cancer cells use this normal and necessary wound healing process in order to increase blood supply (and thereby oxygen and nutrients) to the tumor. The formation of a blood supply allows tumors to grow beyond the size of a pinhead – without angiogenesis they must remain 1-2mm.

The presence of the primary tumor serves to inhibit the growth of metastatic cancer elsewhere in the body. The primary tumor produces anti-angiogenic factors which restricts the growth of metastases. Surgical removal of the primary cancer results in the removal of these anti-angiogenic factors, and the growth of metastasis is no longer inhibited.

In fact, after surgery levels of factors that increase angiogenesis (to heal the wound) – called vascular endothelial growth factor (VEGF) – are significantly elevated. This can result in an increased formation of new blood vessels supplying areas of metastatic cancer – whether from newly formed colonies or from the activation of dormant micrometastases (those pinhead sized tumors that were before angiogenesis unable to be nourished by a blood supply).

Various nutrients have been shown to inhibit VEGF. These include soy isoflavones (genistein), silibinin (a component of milk thistle), chrysin, green tea (EGCG), and curcumin (also see other posts about angiogenesis).

Five days prior to surgery, the patient may consider supplementing with standardized green tea extract, curcumin, soy genistein extract and silibinin.

Surgical Anesthesia can influence Metastasis

The conventional medical approach to surgical anesthesia has been to use general anesthesia during surgery followed by intravenous morphine after surgery for pain control. The may not be the optimal approach.

Morphine weakens the immune system by diminishing NK activity. Studies on mice actually found that morphine increased angiogenesis and stimulated the growth of breast cancer.

One new approach is the use of conventional general anesthesia combined with regional anesthesia (only affects a specific part of the body). The use of regional anesthesia reduces the amount of general anesthesia required during surgery as well as decreasing the amount of morphine needed after surgery for pain control – especially for nausea and vomiting.

Those requiring morphine for pain control post surgery can consider asking for Tramadol instead. Unlike morphine, tramadol does not suppress immune function and has actually been shown to stimulate NK cell activity.

Less Invasive Surgery

Surgery places an enormous physical stress on the body. Surgeries that are less invasive, therefore less traumatic and less stressful, pose less risk of metastasis, compared to more invasive. An example of a less traumatic surgery for the abdomen, and pelvis is laparascopic surgery – where small incisions rather than large, are used.

For lung cancer, video-assisted thoracic surgery (VATS) is a minimally invasive surgery that you might want to consider.

Inflammation

Cancer surgery causes an increased production of inflammatory chemicals. These chemicals increase the activity of cyclooxygenase-2 (COX-2), a highly potent inflammatory enzyme which plays a pivotal role in promoting cancer growth and metastatis. It fuels cancer growth by stimulating the formation of new blood vessels feeding the tumor, by increasing cancer cell adhesion to the blood vessel walls, and enhances the ability of the cancer cells to metastasize.

Initially, COX-2 inhibitor drugs were designed to alleviate inflammatory conditions such as arthritis, but they have been shown to possess powerful anti-cancer activity.

A number of nutritional and herbal supplements are known to inhibit COX-2. These include curcumin, resveratrol, vitamin E, soy isoflavones (genistein), green tea (EGCG), quercetin, fish oil, feverfew, and silymarin (milk thistle).

Pharmaceutical COX-2 inhibitors include Celebrex and NSAIDS, such as aspirin and ibuprofen.

Conclusion

Since cancer-related death is most commonly the result of metastatic disease, it is crucial to minimize this facilitation. Therefore it is essential to be informed and employ preventative interventions during this critical time in order to minimize recurrence and metastatic spread.

I hope that you have found the key points of this article as interesting and important as I did. If you have any questions, please discuss this article with your MD, ND, oncologist – or give me a call and I can point you in the direction of answers.

Click here to link to the Life Extension Cancer Surgery Special Report with supplement guidelines.

Aloo Gobi Curry

I grew up in the Middle East, and I’ve always loved the flavours, aromas and textures of curries. On a beautiful spring day like today when I’ve spent the day working in the garden, there’s nothing easier or more nutritious than a curry.

Curcumin is one of the main ingredients of a curry. You may know it more commonly as turmeric. This versatile spice is antiangiogenic (click on the angiogenesis category to find out more about this) and has benefits for inflammatory diseases like arthritis as well as for diabetes and cancer.

There are three different types of curries – depending on the area the recipe comes from. We’re making a yellow curry today, but there are also red and green curries.

Red Curries

The typical Thai curry is red, and has a good balance of hot, sweet, sour, salty and bitter tastes. The heat can be controlled by the type and number of chilies added to the paste, and can be cooled down by adding coconut milk (a must for curries in my family’s opinion). Palm sugar is usually used to give that little sweetness. The main ingredients are garlic, shallots, red chilies, galangal, shrimp paste, salt, kaffir lime peel, coriander root, coriander seeds, cumin seeds, peppercorns and lemon grass. These ingredients form the base paste to which you can add the vegetables, fruit, meat or fish of your choice.

Yellow Curries

This curry is richer and creamier than the red curry, because of the addition of coconut cream as well as coconut milk. Because of the richness, it tends to not taste as spicy. The primary spices are cumin, coriander, turmeric, fenugreek, garlic, salt, bay leaf, lemon grass, cayenne pepper, ginger, mace and cinnamon.

Green Curries

Green curries tend to be as hot as red curries; however, despite their heat they have a sweetness that is not usually associated with red curries. The main ingredients for the sauce consist of coconut milk, green chilies, shallots, garlic, galangal, kaffir lime peel, roasted coriander and cumin seeds, white peppercorns and shrimp paste.

Aloo Gobi with saffron rice

This recipe was given to me during my cooking course at IHN by Kamsella Nadoo who has since left Toronto for Vancouver I believe. Anyway, its a family favourite and I hope that you enjoy it too.

Step 1

2 Tbsp coconut oil (or ghee)

3 tsp mustard seeds

Put the two together in a covered saucepan on medium heat and leave until the seeds start to pop. Then add

3 tsp urad dhal (like lentils but cook faster – you can replace with 1 can of chick peas which I do often)

Cook for 1-2 minutes.

Step 2

Add

10 curry leaves (or you can use 2 Tbsp curry powder – Lala’s is my favourite brand)

3 dried whole chilies (I’ll be hones and say that I often use a combination of cayenne pepper – not much – and Asian chili sauce as I find whole chilies a little strong for me)

1 tsp turmeric

Cook 1 minute stirring to form a nice paste.

Step 3

Add 1 head cauliflower – chopped into bite-sized pieces

3 large potatoes – I leave the skins on but chop into bite-sized pieces

1 1/4 tsp salt.

Cook covered on low heat for 20 minutes. Garnish with shredded coconut and fresh coriander.

Saffron Rice

2 Tbsp coconut oil or ghee

1 tsp cumin seeds

3 large pinches saffron

Warm spices for 1-2 minutes until fragrant (medium heat)

Add rice (1 cup of basmati rice) and stir and cover for 2 minutes.

Add 2 cups of water (or a combo of half water, half vegetable stock) and boil for 5 minutes, then turn it down to a low simmer – cover and leave for 10  minutes until all of the liquid is absorbed. Once the liquid is absorbed, add 1 can of coconut milk and let simmer again.

At the last minutes, stir in 1/2 red pepper chopped very small, and green peas just until softened. I find that once I add the vegetables to the rice, I call the children to set the table and that’s lots of time.

Notes from last nights dinner:

I replaced the salt with kombu in the soup, and before I added it to the rice noodles it was perfect. But the rice noodles on their own were a little bland (instructions on the package said to pour boiling water over them and leave for 20 minutes). Next time I’ll add some kombu to that water too or a little sea salt for more depth of flavour to the whole meal.

Thanks to Longos “experience” magazine, Spring 2011 issue for the article on curries pp. 34 – 35

Your mother always told you to “eat your vegetables” and its no surprise that she was right. Interestingly enough, the compounds in fruits and vegetables (called polyphenols) that give them their beautiful colours, flavours and taste are the same compounds that have incredible healing properties.

Foods with high levels of healing polyphenols include soybeans, cauliflower, broccoli, cabbage, green tea, fava beans, kale, grapes and the spice turmeric.

Sipping approximately three cups of green tea has been shown to reverse breast cancer in laboratory mice by suppressing the gene that triggers the disease. A daily cup of broccoli sprouts, which has sulforaphane as an active compound, has been shown to reduce the risk of developing many cancers.

The full review is published in the journal Clinical Epigenetics and research more about angiogenesis and epigenetics to discover more about the healing properties of polyphenols.

Photo from http://therawendeavor.com/?p=122 – Yummy Kale Salad recipe!

Recently (September 2010), Dr. Oz interviewed Dr. William Li about his antiangiogenic research. Angiogenesis is the term used to describe the body’s ability to create new blood vessels and capillaries to heal damage to the body. While this is important to maintain homeostasis, there is another time when angiogenesis occurs – and thats when cancer tumors send out angiogenic enzymes and new capillaries are formed to feed the tumor. Not good – because this allows cancer cells to grow and divide at a much faster rate.Dr. William Li has developed several antiangiogenic drug therapies to stop angiogenesis to cancer tumors, but while doing his research he discovered that there are several foods that inhibit angiogenesis.How You Can Eat (and Drink) to Defeat Cancer Eating to defeat cancer can be accomplished simply by adding a few anti-angiogenic foods to your meals each day. Our diet is all about making choices. Since we all eat every day, why not choose foods that can reduce your risk of disease? Listed below are some food facts, supported by scientific research, to help you get the most cancer fighting benefits from your diet. 

• Be picky. Red Delicious and Granny Smith apples have twice as many cancer fighters as Fuji or Golden Delicious apples. The San Marzano tomato contains more cancer fighters than any other variety. Wine grapes grown in cooler climates have more cancer fighters than grapes grown in warmer climates.
• Eat Your Sprouts. Broccoli sprouts can contain more cancer-fighting properties than regular broccoli.
• Dunk Your Teabag. Dunking a green tea bag up and down releases more cancer-fighting molecules than letting the bag just sit in the cup.
• Cook Your Tomatoes. Raw tomatoes are good, but cooking them in olive oil is better. Tomatoes contain the phytonutrient lycopene which, when combined with olive oil, has very strong antiangiogenic capabilities.
• Chew Your Greens. Chewing leafy greens helps to release enzymes that activate cancer-fighting molecules embedded deep in the leaves.
• Go Soy. Fermented soy, like the kind used in miso soup, and tempeh, contains four times more cancer fighters than regular soybeans.
• Choose one cancer fighting food for each meal. We eat at least 3 meals each day, that adds up to more than a thousand of cancer fighting food opportunites each year.
• Foods from the brassica family are antiangiogenic – brassicas include broccoli, cabbage, cauliflower, bok choy, kale, Brussels sprouts, rapini.
• Berries, like raspberres and strawberries, contain ellagic acid in their seeds. Ellagic acid is both an antioxidant and antiangiogenic.
• Omega 3 EFAs – found in white fish like flounder and flax seed oil – are antiangiogenic.

There’s lots more of Dr. William Li’s research available at http://www.angio.org/.  Also, there’s another video of his lecture at TED that’s very interesting and informative.

Incoming search terms:

• dr william li
• william li tea blend
• xiong li china green tea