Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

Original Link

Topical Application of Turmeric Curcumin for Cancer

NF-Oct27 Topical application for turmeric curcumin for cancer .jpg
In my video, Turmeric Curcumin and Colon Cancer, I talked about a study where researchers showed that, by taking curcumin, the yellow pigment in the spices turmeric and curry powder, those at high risk for colon cancer could cut down on precancerous and even pre-precancerous lesions, in effect reversing cancer progression. Are there other high risk lesions we can try spicing up?

How about giving turmeric extracts to people who just had bladder cancer taken out? Or to those who have an early stage of squamous cell carcinoma skin cancer caused by arsenic exposure, or early stage cervical cancer, or precancerous lesions in the mouth or stomach? Researchers did this, and in about a quarter of the patients, the lesions started to get better. One out of the two bladder cancer survivors, two out of seven patients with precancerous mouth lesions, one out of six patients with precancerous stomach lesions, one out of four early stage cervical cancer cases, and two out of six patients with early stage skin cancer, all without any noticeable side-effects.

One of the reasons turmeric curcumin may work in some cancers better than others, or in some people better than others, is differences in bioavailability. Megadoses were given, yet just a tiny amount ended up in the bloodstream. If we're treating skin cancer, though, why not just put the curcumin directly on the skin?

I've talked about what turmeric compounds can do to cancer cells in a petri dish. In the video, Topical Application of Turmeric Curcumin for Cancer, you can see some before and after pics. Cervical cancer cells are laid to waste as more and more curcumin is added, and normal cells are unharmed. But to make it to the cervix, curcumin must be absorbed (though a vaginal cream has been invented).

A variety of delivery methods have been devised, including oral, intra-abdominal, intramuscular, under-the-skin injections, straight into the veins or the arteries, on the skin, up the bladder, in the nose, breathed like an inhaler, up where the sun don't shine, or straight into the spinal column, bone marrow, the tumor itself, or implanted somehow. Taken orally, some curcumin does actually get into the tissues. We can measure the amount of curcumin absorbed into the wall of the intestine by examining biopsies and surgical specimens taken after a curcumin regimen. It makes sense to take turmeric orally to try to fight colon cancer, but if we have cancer erupting on our skin why not just rub it on directly?

That's what one group of researchers did. They took some turmeric from the store, made a tincture out of it, dried it, put it in Vaseline, and then had cancer patients rub it on their cancer three times a day. What kind of cancer can you get at with a finger? These were folks with cancers of the mouth, breast, skin, vulva, and elsewhere. Isn't breast cancer under the surface? Not always. Advanced breast cancer can ulcerate right through the skin. The subjects were all people with recurrent ulcerating tumors that had failed to respond to surgery, radiation, and chemo. These open cancers can stink, itch, and ooze, and there was nothing else medicine had to offer. So they rubbed some turmeric ointment to see what happened. It produced remarkable relief. A reduction in smell was noted in 90% of the cases, even in extensively ulcerated cases of breast cancer, and a reduction in itching in almost all cases as well. For example, treatment relieved severe itching in two of the vulva cancer patients. Most of the lesions dried up, and in many cases this relief lasted for months, all from just rubbing on the harmless spice turmeric, which the researchers describe as "an indigenous drug ... highly effective in reducing smell, itching and exudate." The effect of this so-called drug is remarkable. And that "drug" is just some edible spice used in curries for centuries.

More on what this golden spice can do in:

There are ways of Boosting the Bioavailability of Curcumin to get it into our blood stream.

Some should be cautious about turmeric use, though. See Who Shouldn't Consume Curcumin or Turmeric?

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Andrea Kirkby / Flickr

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How Phytates Fight Cancer Cells

NF-May26 Phytates for Rehabilitating Cancer Cells.jpg

Phytate is a compound found in beans, grains, nuts and seeds. The average daily intake of phytate in vegetarian diets is about twice that of those eating mixed diets of plant and animal foods, which may help explain their low cancer rates. Aside from helping to prevent cancer, dietary phytate has been reported to help prevent kidney stone formation, protect against diabetes mellitus, dental cavities, and heart disease.

Do all these potentially beneficial effects sound too good to be true? Are there other examples of compounds made by plants that can have benefits across multiple diseases? Why yes! Aspirin, for example, which is found throughout the plant kingdom may also account for a variety of plant-based benefits (See Aspirin Levels in Plant Foods).

But of all the things phytates can do, the anticancer activity of phytate (also known as phytic acid, IP6, or inositol hexaphosphate), is considered one of its most important beneficial activities. Dietary phytates are quickly absorbed from the gastrointestinal tract and rapidly taken up by cancer cells throughout the body, and have been shown to inhibit the growth of all tested cancerous cell lines in vitro. Phytates have been shown to inhibit the growth of human leukemia cells, colon cancer cells, both estrogen receptor-positive and negative breast cancer cells, voicebox cancer, cervical cancer, prostate cancer, liver tumors, pancreatic, melanoma, and muscle cancers. All at the same time not affecting normal cells. That's the most important expectation of a good anticancer agent: the ability to only affect cancerous cells and to leave normal cells alone.

In my video, Phytates for Rehabilitating Cancer Cells, you can see how leukemia cells taken from cancer patients are killed by phytates, whereas normal bone marrow cells, are spared. This may explain why bean extracts kill off colon cancer cells in vitro, but leave normal colon cells alone.

What are the mechanisms of action by which phytates battle cancer? In other words, how do phytates fight? How don't they fight? Phytate targets cancer through multiple pathways, a combination of antioxidant, anti-inflammatory, immune-enhancing activities, detox, differentiation, and anti-angiogenesis. In other words, phytate appears to affect all the principal pathways of malignancy.

The antioxidative property is one of the most impressive characteristics of phytate. In fact that's why the meat industry adds phytates to meat to prevent the fat oxidation that begins at the moment of slaughter. Phytates can also act on our immune functions by augmenting natural killer cell activity, the cells in our body that hunt down and dispose of cancer cells, as well as neutrophils, which help form our first line of defense. And then phytates starve tumors as more of a last line of defense. Not only can phytates block the formation of new blood vessels that may be feeding tumors, but disrupt pre-formed capillary tubes, indicating that phytates may not just help blockade tumors, but actively cut off existing supply lines.

What's really remarkable about phytate, though, is that unlike most other anti-cancer agents, it not only causes a reduction in cancer cell growth but also enhances differentiation, meaning it causes cancer cells to stop acting like cancer cells and go back to acting like normal cells. You can see this with colon cancer cells for example. In the presence of phytates, human colon cancer cells mature to structurally and behaviorally resemble normal cells. And this has been demonstrated in leukemia cells, prostate cancer, breast cancer, and muscle cancer cells as well.

For more on the cancer and phytate connection, check out Phytates for the Prevention of Cancer and Phytates for the Treatment of Cancer.

This video reminds me of my video on the spice, turmeric, Turmeric Curcumin Reprogramming Cancer Cell Death.

What else can we eat to improve the cancer-fighting front of our immune system? See Boosting Natural Killer Cell Activity.

More on the concept of starving tumors of their blood supply in Anti-Angiogenesis: Cutting Off Tumor Supply Lines.

Is there clinical evidence of plants actually reversing cancer progression? You won't believe your eyes:

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Avi / Flickr

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The Spice That Helps Ease Rheumatoid Arthritis Pain

NF-Jan22 The Spice that Helps Ease Rheumatoid Arthritis Pain.jpg
Accordingto the World Health Organization, "80% of the Earth's inhabitants rely upon the traditional medicine for their primary health-care needs, in part due to high cost of Western pharmaceuticals. Medicines derived from plants have played a pivotal role in the health care of both ancient and modern cultures." One of the prime sources of plant-derived medicines is spices. Turmeric, for example, has been consumed over the centuries around the world. Turmeric is known by different names in different societies--my favorite of which is probably "zard-choobag."

Turmeric is the dried powdered root stalks of the turmeric plant--a member of the ginger family--from which the orangey-yellow pigment curcumin can be extracted. The spice turmeric is what makes curry powder yellow, and curcumin is what makes turmeric yellow. In the video, Turmeric Curcumin and Rheumatoid Arthritis, you can see the molecular structure of curcumin. I always thought it kind of looked like a crab.

In recent years, more than 5,000 articles have been published in the medical literature about curcumin. Many sport impressive looking diagrams suggesting curcumin can benefit a multitude of conditions via a dizzying array of mechanisms. Curcumin was first isolated more than a century ago, but out of the thousands of experiments, just a handful in the 20th century were clinical studies, involving actual human participants. Most of the 5,000 were just in vitro lab studies, which I've resisted covering until the studies moved out of the petri dish and into the person. But since the turn-of-the-century, more than 50 clinical trials have been done, testing curcumin against a variety of human diseases, with 84 more on the way. One such study got my attention.

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that causes progressive destruction of the cartilage and bone of joints. The long-term prognosis of RA is poor, with as much as 80% of patients affected becoming disabled with a reduced life expectancy. There are lots of drugs one can take, but unfortunately they're often associated with severe side effects including blood loss, bone loss and bone marrow suppression, and toxicity to the liver and eyes.

The efficacy of curcumin was first demonstrated over 30 years ago in a double-blind crossover study: curcumin versus phenylbutazone, a powerful anti-inflammatory that is used in race horses. Both groups showed significant improvement in morning stiffness, walking time, and joint swelling, with the complete absence of any side effects from curcumin (which is more than can be said for phenylbutazone, which was pulled from the market three years later after wiping out people's immune systems and their lives).

In the new study, 45 patients diagnosed with rheumatoid arthritis were randomized into three groups: curcumin, the standard of care drug, or both. The primary endpoint was a reduction in disease activity as well as a reduction in joint tenderness and swelling. All three groups got better, but interestingly the curcumin groups showed the highest percentage of improvement, significantly better than those in the drug group. The findings are significant and demonstrate that curcumin alone was not only safe and effective, but surprisingly more effective in alleviating pain compared to the leading drug of choice, all without any adverse side effects. In fact, curcumin appeared protective against drug side effects, given that there were more adverse reactions in the drug group than in the combined drug and curcumin group. In contrast to non-steroidal anti-inflammatory drugs (NSAIDs), curcumin has no gastrointestinal side effects, and may even protect the lining of the stomach.

Hard to appreciate the gorgeous color of fresh turmeric root unless you see it for yourself. You should be able to find it at any large Asian store. I incorporate it into my Natural Nausea Remedy Recipe. The inner color is almost fluorescent!

I'm afraid followers of NutritionFacts.org are going to get sick of turmeric, but there's a load of important new research I felt I needed to cover. So far there's Turmeric Curcumin and Osteoarthritis, Boosting the Bioavailability of Curcumin and Who Shouldn't Consume Curcumin or Turmeric?

I've previously talked about treating autoimmune joint inflammation with diets full of plants in Diet & Rheumatoid Arthritis and Potassium and Autoimmune Disease.

If phenylbutazone sounds vaguely familiar, maybe you read my Q&A Is horse meat safe to eat?

-Michael Greger, M.D

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: David van Horn / Flickr

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