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| Medicine and nutrition are synergistic sciences |
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| Nutrition science is well established |
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“Cancer metastasis involves a complicated biochemical ‘conversation’ between the seed and the soil.”
Stephen Paget, MD, Lancet, 1889
“The time has come to put major emphasis on the soil.”
Isaiah Fidler, MD 2004, MD Anderson Cancer Center
WHAT'S AHEAD?
Nutrition can make medical therapy more of a selective toxin against the cancer and less damaging to the patient. Nutrition therapy is an essential part of comprehensive cancer treatment because:
> malnutrition kills 40% or more of cancer patients
> nutrition protects the patient against the toxic effects of chemo and radiation without reducing their effectiveness in killing cancer
> nutrients support the immune system in killing cancer
> sugar feeds cancer (think of how a PET scan works), which makes diet and supplements crucial
> nutrients can become "biological response modifiers" in changing the way the body works to re-regulate the cancer cells
Can you imagine any state of being--heart disease, pregnancy, broken bone, depression, splinter, flu, or cancer--in which being malnourished is an advantage for recovery? This chapter offers some insights regarding the guided use of nutrition therapy to help support your cancer patient while undergoing traditional therapies. You will be spared the onslaught of references in this chapter, though ample scientific documentation is found throughout this book to support the use of nutrition as part of comprehensive cancer treatment. No one is saying that nutrition should be the sole therapy in advanced cancer. It is hoped that you will consider using aggressive nutrition to bolster “host defense mechanisms” in your cancer patients.
MISCONCEPTIONS ABOUT NUTRITION & CANCER
The concept of nutrition in cancer treatment comes with a mixed reputation, although its use dates back 2,000 years ago to Chinese medical textbooks.
==>FALSE HOPE. You may have heard the undocumented claims regarding cures from advanced cancer using carrot juice. You have also seen more than a few advanced salvageable cancer patients waste precious time “experimenting” with questionable treatment modalities, only to have the patient succumb to the disease.
==>QUESTIONABLE PRACTITIONERS. To be sure, there are a few unsavory characters in the field of nutritional oncology, just as there are in any profession.
==>IF YOU FEED THE PATIENT, THEN YOU FEED THE CANCER. You may have been trained by the founders of chemotherapy, who exploited folic acid antagonists as drugs to slow down neoplasia. It would seem that “if an anti-vitamin (methotrexate) slows down cancer, then a vitamin might accelerate cancer. “ In fact, nutrients in general bolster the patient’s ability to recover from most diseases. You will see many references throughout this book showing how nutrients improve outcome in cancer treatment. You will also see that some essential nutrients, notably sodium, glucose, iron, copper, and the essential fatty acid of linoleic acid, can accelerate tumor growth when used in excess or in the absence of other controlling nutrients. This book addresses the concepts of nutrient toxicity and provides guidelines for using nutrition as a positive force in the treatment of your cancer patients.
You may have seen the paper from the American College of Physicians (Annals of Internal Medicine, vol.110, no.9, p.734, May 1989) claiming that total parenteral nutrition (TPN) may be counterproductive in cancer patients. Paradoxically, malnourished patients were eliminated from this meta-analysis of pooled data. TPN treats malnutrition, not cancer. Also, this collection of studies grouped various TPN protocols together; those that were high in dextrose or low, high in protein or low, with or without fat...all were considered as equal TPN formulas against cancer. Since cancer is an “obligate glucose metabolizer”, or sugar-feeder, and since the patient needs adequate amounts of protein to rebuild lost visceral protein stores and replenish the immune system, it is unwise to group all TPN formulas together. Other studies show that the proper formula of TPN along with proper patient-selection criteria can improve the outcome in cancer treatment.
==>ANTIOXIDANTS WILL REDUCE THE EFFECTIVENESS OF CHEMO AND RADIATION.
In basic theory, this statement makes sense. However, in actual human cancer patients, antioxidants have been shown to dramatically improve the tumor kill from pro-oxidative chemo and radiation, while protecting the host tissue from damage. Essentially, the proper selection of nutrients taken before and during chemo and radiation can help make the medical therapy more of a selective toxin against the cancer. In one study, cancer patients were given either vitamin E at 300 mg per day or placebo while undergoing cisplatin therapy. Only 31% of the vitamin E group developed neurotoxicity, while 86% of the placebo group developed neurotoxicity. There was no observed difference in tumor kill rate.
Cancer cells are primarily anaerobic, fermenting cells. With the exception of vitamin C, cancer cells do not absorb nor use antioxidants the same way that healthy aerobic cells do. Vitamin C (ascorbic acid) is nearly identical in chemical structure to glucose, which is the favored fuel for cancer cells. With this background, it should not be surprising that researchers at Sloan-Kettering found that radioactively labelled ascorbic acid was preferentially absorbed by implanted tumors in animals. The study admitted that this effect takes place because cancer has many more glucose receptors on the cell surface than healthy normal cells. The researchers then assumed, but never found any evidence, that vitamin C should not be used in conjunction with chemo or radiation because the tumor was absorbing vitamin C to protect itself against the damaging effects of chemo and radiation. Any antioxidant by itself and/or in an anaerobic environment (such as a cancer cell) can become a pro-oxidant. Vitamin C in large doses in cancer patients is both protective of the patient while allowing therapy to be more toxic to the tumor cells.
We can exploit the differences in biochemistry between healthy and malignant cells by combining aggressive nutrition support with restrained cytotoxic therapies.
==>CANCER MUST BE TREATED WITH CYTOTOXIC THERAPY, NOT NOURISHMENT. That strategy may be changing. An article by an oncologist published in the Journal of Clinical Oncology (vol.13, no.4, p.801, Apr.1995) asks the question: “Must we kill to cure?” Over the past 50 years, we have found that increasing the toxicity and usage of pesticides on insects in the fields has created a net INCREASE in crop loss, with some insects developing near-total immunity to the most potent insecticides. During the same half-century, we have overused antibiotic drugs, with the net effect that infections are now the number three cause of death in America, with some bacteria having become virtually drug-resistant. During that same time frame, we have attempted to use potent systemic chemotherapy to eliminate cancer. Initially, the patient often gets a “response”, or a shrinkage of the tumor. In many patients, the tumor soon develops a drug resistance that creates a more virulent tumor, yet at that point the chemotherapy may have compromised the patient’s host defense mechanisms and thus, his ability to recover. Attacking cancer with restrained medical intervention COUPLED with aggressive nutrition is the best strategy. These two therapies combine to create a synergistic response that is better than either therapy could achieve on its own.
==>WHAT QUALIFIES PATRICK QUILLIN? You might ask, “With all the conflicting information out there regarding nutrition for cancer patients, why is this guy the one to listen to?” In addition to my three earned degrees in nutrition, and my certified nutrition specialist (CNS) status, I have spent 15 years working with over 3,000 cancer patients and know what works and what doesn’t. I organized 3 international continuing medical education scientific symposia on "adjuvant nutrition in cancer treatment" and edited a textbook by the same name. My original release of BEATING CANCER WITH NUTRITION has been translated into Japanese, Korean, and Chinese and was a home-study continuing education course for registered nurses, and was the bestseller in its category on amazon.com for 1999. Please see my complete curriculum vitae at my website: www.NutritionCancer.com.
The bottom line is that a well-nourished cancer patient can better manage the disease, and has fewer infections, fewer side effects from chemo and radiation, a better quality and quantity of life, and improved chances for complete remission. The toxicity of professionally-designed nutrition therapies for the cancer patient is near-zero. The risk-to-benefit-to-cost ratio of nutrition therapy in cancer treatment warrants its inclusion.
I have worked with many cancer patients who came to our centers as the “hospital of last hope” after failing several different chemo and radiation protocols. Many of these patients were in tears as they would tell me about the apathy that their former doctors displayed as the patient asked the doctor: “What about nutrition? Might it help?” As you will see in studies throughout this book, the earlier the cancer patient receives nutrition therapy, the better the outcome. For those patients who are malnourished or who have been through extensive cytotoxic therapies without any nutrition support, the recuperative powers of the human body can be exhausted.
By keeping an open mind and the patient’s best interests in the forefront, you will make the right decision in using nutrition for your patients. Thank you in advance for your time and consideration.
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