Topic: Can eating healthy prevent a cancer recurrence?

I've read some articles to that effect especially in respect to triple negatives.  I'm quoting the study here:

The Study

The Women's Intervention Nutrition Study (WINS) was a large, prospective, randomized phase III study to investigate whether a low-fat diet could reduce breast cancer recurrence rates in postmenopausal women who had been treated for early-stage breast cancer. Postmenopausal women were chosen because they tend to have less variability in their types of breast cancer than premenopausal women.

Between 1994 and 2001, the study enrolled 2,437 women who in the previous year had had breast cancer surgery followed by therapy appropriate to their particular cancer. The women, whose average age was 62 were randomly assigned to one of two dietary groups. One group was asked to follow their standard diet. Women in this group met with a nutritional counselor periodically but were not urged to change their diet, which contained an average of about 51 grams of fat a day (about 40 percent of total calories from fat).

Women in the second group were asked to modify their diet to reduce their consumption of dietary fat to 20 percent of total calories. Each woman received eight one-on-one dietary counseling sessions with a nutritionist (one every other week for 16 weeks). After that, they saw the nutritionist every three months for the duration of the study. The nutritionist offered support and advice about reducing dietary fat consumption by, for example, using less oil when cooking, increasing intake of fruit and vegetables, controlling portion sizes, and so on. The diet eaten by women in the low-fat group contained an average of 33 grams of fat a day.

Women in both groups kept diaries in which they recorded their daily food consumption. In addition, trained interviewers periodically contacted all of the women by phone to question them about what they were eating.

Encouraging women to have more active lifestyles was not a goal of the study, said principal investigator Rowan T. Chlebowski, M.D., Ph.D, of the Los Angeles Biomedical Research Institute in California. Most women in both the standard-diet and low-fat diet groups had sedentary lifestyles.

Results

After a median of five years of follow-up, breast cancer had come back in 9.8 percent of the women on the low-fat diet and 12.4 percent of those on the standard diet. This amounted to a 24 percent reduction in the risk of recurrence for the women on the low-fat diet.

The largest risk reduction - 42 percent - was seen among women on the low-fat diet whose tumors did not respond to the presence of the hormone estrogen. Breast cancer that doesn't respond to estrogen is called estrogen receptor negative (ER-negative) and usually has a poorer outlook than ER-positive disease. Postmenopausal women whose tumors do respond to estrogen are candidates for anti-estrogen drugs such as tamoxifen or letrozole, which help reduce the risk of relapse.

Although weight loss was not a goal of the study, women who followed the low-fat diet lost an average of four pounds, said Chlebowski.

(Note: final results from this study were subsequently published in the Dec. 20, 2006, Journal of the National Cancer Institute; see the journal abstract and the related NCI press release.)

Limitations

The research team cannot be certain that the low-fat diet was responsible for the lower rate of recurrence in the women assigned to that group, said Chlebowski. Other factors, such as the modest weight loss seen in the low-fat group or increased consumption of fruit and vegetables, may have contributed to the outcome.

Additionally, some, but not all, women in both study groups were treated with chemotherapy following surgery. The researchers have not yet analyzed whether chemotherapy was associated with improved survival.

Comments

These results suggest that an intervention aimed at reducing dietary fat consumption can reduce the risk of breast cancer recurrence, said Chlebowski. Although further confirmation is needed, he said a low-fat diet may offer other health benefits, such as modest weight loss.

It may be reasonable for physicians to suggest that postmenopausal women who have been treated for breast cancer consider following a low-fat diet because of these other health benefits, he concluded.

"This is one of the very few controlled intervention studies [in the field of cancer prevention] where we can truly monitor the efficacy of the intervention," said John Milner, Ph.D., of the National Cancer Institute's Division of Cancer Prevention. "Monitoring was done every three months, which is far better than in many trials. I have a lot of faith in this study."

Milner also noted that "we have few options to offer women with ER-negative tumors" in terms of preventing a recurrence of their cancer, and so this study's suggestion that a low-fat diet may be particularly effective for them "is exciting news."

Also, exercise is one of the tried and true methods to help reduce recurrence for all cancers.

I hope this helps!

Lorrie 

Angel-

I absolutely believe that you can keep cancer dormant with diet and exercise.

I think you might be interested in a book called "The China Study" by T. Colin Campbell. I think you would find a lot of good information there. I know that I am following the diet suggested by Dr. Campbell and it is my only hope of preventing a cancer recurrence. There are other books I could recommend as well if you are interested.

Good luck

The cause or causes of cancer have been debated for hundreds of years. Now, because there is technology to look at the gene, the focus has become the gene. Many markers, genetic amplifications, point mutations, etc. have been found that supposedly delineate hard-coded genotypic changes that lead to cancer for specific organs and tissues. And the list continues to grow. However, many of these so-called mutations may be found in healthy cells. The question then becomes whether genetic changes are the real molecular cause of cancer? Research over the past few years suggests that they are not.

Epigenetic modifications are potentially reversible changes in gene function that occur without a change in DNA sequence (genotype). In other words, epigenetic changes come from how the gene is expressed not the hard-wiring of the genetic sequence or code itself. And some of these epigenetic modifications are now being identified with carcinogenesis. According to researchers at the University of California at San Francisco, "DNA methylation and histone modifications are important epigenetic mechanisms of gene regulation and play essential roles both independently and cooperatively in tumor initiation and progression." For example, the hypermethylation of some regulatory regions (i.e. CpG islands) can inactivate some tumor suppressor genes (i.e. BRCA1, hMLH1, p16INK4a, APC, VHL).

The critical role that epigenetic changes play in cancer etiology has been identified through a number of subtle experiments. One in particular is worth mentioning. A study at a major Children's Hospital using a mouse model transferred the cell nucleus from a medulloblastoma cell (a type of aggressive brain cancer mainly found in children) to a normal cell. Incredibly, the nucleus from the cancer cell nucleus did not turn the normal cell into a cancer cell. One of the researchers concluded that the study, "Shows that so-called epigenetic factors are key elements in the development and maintenance of tumors."

So why is this important? It's important because evidence suggests that the epigenome can be influenced by the environment which means that epigenetic modifications that lead to carcinogenesis may be reversible by changing the environment. (Does this help explain observations regarding pleomorphic theory - that bacteria actually become modified as the environment changes?) This also implies that orthodox and experimental therapies have failed because they are missing the big picture. For example, chemo and radiation both try to destroy every single transformed cell with cytotoxic therapies. Beyond the statistical improbability of this approach, how rational is it when the biological and cellular environment has created and is probably continuing to create epigenetic changes leading to cancer in the first place. (Does this explain why patients with hematological cancers relapse after allogeneic stem cell or bone marrow transplantation?)

Even gene therapy which is a reasoned theory may actually be a misinformed therapy because it aims to insert genes into an individual's cells. Assuming that you could supplement a defective mutant allele with a functional one, how does that help when the problem may reside outside the genetic code? Instead, if epigenetics are as important to cancer as they seem to be, the goal should be to change the environmental conditions that led to the epigenetic modifications in the first place.

So what effects epigenetics? We know that toxins and carcinogens induce important epigenetic alterations that can lead to cancer. Can the removal of toxins and carcinogens reverse the unhealthy epigenetic state? If it can it will provide a biochemical and genetic basis for what alternative practitioners have been saying for years - that detoxification followed by the creation of a healthy milieu with appropriate diet and supplements benefits cancer patients. Unfortunately, that simple question may go unanswered for some time because most researchers in this area are taking the predictable approach based on reductionism. They believe they can manipulate this subtle and complex system (i.e. changing our epigenome) by focusing on singular mechanistic aspects. (This approach is often driven by the pharmaceutical industry which needs to patent specific molecules in order to control their market price.) While basic bench science is needed to understand the pathways, a more valuable approach to changing the epigenome may actually come from nutrition.

For example, when scientists at Duke University changed the diet of agouti mice (large fat mice that are susceptible to cancer and diabetes) their offspring were slender and brown and did not display the parent's susceptibility to these chronic diseases. One of the researchers was quoted as saying, "It was a little eerie and a little scary to see how something as subtle as a nutritional change in the pregnant mother could have such a dramatic impact on the gene expression of the baby." And in November 2003 researchers at Rutgers found that green tea could prevent cancer in animals through epigenetic pathways.

So the question remains - can diet change one's epigenome and if so can it change the epigenome of a cancer cell so it becomes a healthy cell?

Gene and Epigene - The Next Cancer Therapy?

http://www.cancermonthly.com/blog/2007/12/cancer-gene.html

Baywatcher

I would really appreciate it if you could give me the names of the other books.

Thanks for the note, Lorrie.  I really believe a healthy diet is essential to reducing risk of recurrence. And it is something WE can control.  (Of course, my wonderful cook of a husband is making enchiladas right now, so I will fall off the wagon tonight.  They are spinach, though.)

My feeling is that it can't hurt.

The Anti-Cancer by David Servan-Schreiber is a great resource.  And, it isn't over-the-top.

Dr. Furhman's Eat for Health is also good.  http://www.drfuhrman.com/

Finally, Kris Carr in Crazy, Sexy Cancer has some good tips.  However, she is a little over the top.

I haven't been on the board for a couple of days because my daughter just delivered my first grandchild!!!! It is a boy and mother and son are doing well.

Hrf- To answer your question in a nutshell. Doctor Campbell says that dairy is a cancer promoter. He describes it this way. If you plant grass seed but don't give it any water, the grass seed stays dormant. Once you add water, the seed sprouts and grows. Dr. Campbell says that cancer acts the same way. He found that you can turn cancer on with dairy. So if there are cancer cells in your body, dairy fuels the cells. Doctor Campbell says that people get too much protein. He advocates a plant based whole food diet. He says that you should minimize fish and refined carbs but cut out meat and dairy. The China Study makes a lot of sense to me. You can probably get it at the library. You might find it very interesting.

Angel- Another good book is "Food for Life" (how the new four food groups can save your life) by Dr. Neal Barnard. Also, the two books mentioned by Michele being "Anti-Cancer" and "Crazy Sexy Cancer".

There is also a movie called "Food Inc". It was recently at theatres and you can probably get it on Netflix or somewhere else. When you see it you realize how bad and unhealthy factory farming is. No wonder so many people are sick.

Also, a benefit of eating as Dr. Campbell suggests, I have lost 20+ pounds and eat all I want. I also try to walk more to get exercise.

I feel healthier than ever and if I could just get my messed up head under control I would be in good shape.

I think part of it is a crap shoot. There are no guarantees in life. But I am betting on this for my health.

I doubt it.

(Eating healthfully didn't prevent me from getting the first one.)

tl

I see a lot of posts from people who say they had a "healthy" diet before cancer so diet has no effect - I think if their actual diets were compared to the ones in books like Anti cancer, you would find they fall pretty short of what is recommended as a diet to fight cancer.

I think for most of us (those without BRCA or other mutations) there is definitely an environmental component.  Whether that is due to diet, exercise or other factors such as pollution, who knows?  The best we can do is to make changes to help ourselves stay healthy from here on out.  I don't feel that questioning our pre-cancer choices puts any blame on us, it's just an opportunity to improve our chances of not having to fight this beast again.  I find that empowering, especially since TN's don't have the drug options that other breast cancer survivors do.

Personally, I've made changes in my diet and exercise. I've lost weight and feel lots better. And maybe these lifestyle changes will help prevent a recurrance down the road.

I guess my concern is that I can visualize some newbie happening across this thread and getting even more upset about things, thinking that she caused her BC to happen. Whether her lifestyle choices had any correlation to her BC is beside the point, for me.

I just don't want the newbie to freak out any more, which is why I chose to post a differing opinion on this thread so a newbie would see that we are not all in agreement on this topic. I honestly do believe that it's a crap shoot but I respect your decision to believe otherwise.

--CindyMN

This is powerfuland incredible info about diet. I hope to work with a good dietician and not one who is secretly part of a research study where I'mm the lab rat...

but get good advice and help so I can make the diet changes to help me from not having a reoccurance.

Glad to find this thread, I was wondering about this topic. I believe diet is important cancer or no cancer... but more so now with the cancer.

I plan to modify my diet and go law fat, work on getting weight down and keeping it down.

Not just for the cancer but for heart and bones. I never ate right so this will be new for me to try.  It's my belief diet can help you no metter what your problems are. I never feel good after eating a high fat, sugary food.... but I have, mostly because I'm not into cooking, which needs to change.

Was wondering... is Triple negative breast cancer a BRCA 1 cancer? BRCA2?

if I have triple negative, does this mean I would be a BRCA positive person where I could have known about getting this cancer? I dont seem to understand the info I'm getting online about BRCA...