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.

I’m not hearing any buses yet, so I’m going to keep on writing!

Lately, Sherri and I have been working away at creating delicious Gluten-Free baked goods recipes (crackers, muffins, cookies, cakes, buns, breads) for our teaching kitchen and I realized this morning that this is a problem. These baked goods are for ‘occasional’ meals only. As a society we have relied heavily on them as the backbone and focus of our meals and snacks – to the detriment of our health. Instead of looking at ways of making gluten-free, sugar-free, dairy-free baked goods, let’s concentrate on foods that are really going to heal and nourish our bodies.

Turn the page to VEGETABLES!

We can make a healthy choice to focus instead on finding delicious ways to fill at least half of every plate we eat with vegetables. This is the foundation. There are endless combinations and permutations we can combine to make delicious smoothies, spreads (for cucumbers, celery, slices of raw turnip, sweet potatoes, celery root), salads, stir fry’s or roasted vegetables. And when we add fruit to the mix, the sky’s the limit!

My favourite guide is George Mateljan’s book (and website) The World’s Healthiest Foods. The world’s most nutrient-dense foods do not lie in the animal protein list – but fall instead in the Vegetables list! Surprised? Topping the list – spinach, swiss chard, crimini mushrooms and asparagus. Of a three column list, two of the columns include vegetables, fruit, beans and legumes, herbs and spices and nuts and seeds. Grains are near the bottom with dairy and eggs and poultry and lean meats. Fish and shellfish lie between the two groups.

So, for the next week, I’m going to change my focus and start learning about the wonderful tastes and vitality of healthy, nutrient-rich vegetables. In the morning, I enjoy whole grain granola (and I’ll give you the recipe in case you would like to try it) with home-made kefir topped with fresh fruit. I’m trying to get the kids to have a smoothie to take with them to school for breakfast, but am still perfecting that option. For lunch, I usually have a salad with the leftovers from dinner before, or in the winter a salad with some soup. But I’m going to experiment more with combining beans and vegetables probably with some grains like quinoa and buckwheat. As for dinner, vegetables steamed, stir-fried, roasted and drizzled with a little olive oil or flax oil and seasoned with herbs, along with some lean meat or fish seasoned with fresh herbs. If I need a sweet later on, I’ll have some fresh fruit with a little more granola or sprinkled with flax seeds.

I’ll be honest, usually about 9:30 we have a “cup of tea” as a family which usually includes a cookie. Maybe this is the ‘occasion’. How many cookies or baked goods per week is the “right” amount? From my years of yo-yo dieting and bulimia, the one thing that I do KNOW is that once I put restrictions on the food that I am allowed to eat, I crave that restricted food. So I cannot answer that question. I think that the answer is different for each of us. But I do think – and will research this over the coming weeks – that if I fill my body with healthy, nutritious vegetables and fruits, I may not want a cookie or sweet at night.

I’ll be fully nourished.

Interesting thought!

Sautéed Asparagus

1 lb of asparagus, bottom twiggy section snapped off and the rest cut into 2 inch sections
3 Tbsp of vegetable broth

Heat the broth in a skillet over medium heat. Once it starts to steam, add the asparagus. Cover and cook for 5 minutes. Transfer to a bowl and toss with the Dressing for the buckwheat below.

Pan-Fried Perch

1 lb of fresh perch
2 Tbsp olive oil
2 Tbsp vegetable broth
2 cloves garlic, minced

Heat the broth and olive oil under medium heat, add the minced garlic and sauté for 2 minutes. Add the perch skin side down and cover. Fry for 3 – 5 minutes until the meat looks white and flakey. Remove from heat and serve.

Buckwheat Salad with Chick Peas, Cucumber, Tomatoes and Fresh Parsley

1 cup buckwheat (I used Kasha or toasted buckwheat)
2 cups water
1/2 tsp sea salt

½ can chick peas, drained and rinsed
½ English cucumber, small cubes
½ red onion, halved and thinly sliced
handful small grape tomatoes, halved
handful chopped fresh parsley

Dressing (make up and save as an easy salad dressing)
1/2 cup extra virgin olive oil
1/3 cup fresh lemon juice
zest of lemon
4 cloves garlic
Sea salt and pepper to taste

Cook the buckwheat – put first three ingredients together in pot and cover. Bring to a boil for a minute, then turn down to low and simmer for 10 – 12 minutes. Buckwheat is fully cooked when it is dry and fluffy. Do not stir the buckwheat while it is cooking.

Press garlic and let sit for 5 minutes (allows the health-promoting nutrient allicin to form). Whisk together with olive oil, lemon juice, garlic, salt and pepper.

Toss the buckwheat with the vegetables and chopped parsley and dress to taste. Serve on a bed of lettuce or spinach.

I’m going to add a photograph once I’ve got it all put together. New experience!