The Breast Cancer Prevention Diet

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" INTRODUCTION
For decades, breast cancer has stood alone among major diseases, because its victims lacked even a single practical preventive measure with which to protect themselves. In most epidemics, we've had the power to defend ourselves: vaccines for the flu, lowered cholesterol for heart disease, smoking cessation for lung cancer, lowered blood pressure for stroke, and safe sex for AIDS. But despite the decades-long, terrifying increase in new breast cancer cases, women have stood virtually powerless to prevent the disease. That had left a quiet sense of desperation among survivors like 37-year-old Deborah McCurdy, mother of four. Deborah had advanced breast cancer that required four cycles of intensive chemotherapy, aggressive radiations and a bone marrow transplant "My little girl was only two. I had to live to see her grow up."
Deborah finally has a chance to do just that. The good news is this: In the spring of 1998 there emerged the first real hope for women like Deborah that breast cancer might be prevented. Years of investment in breast cancer research is finally beginning to pay off and yield major discoveries by leading scientists working in North America and Europe in nearly a dozen different scientific fields. Most of these discoveries were unveiled in bits and pieces and so are virtually unknown to the public at large, with little drawn together into a comprehensive plan. What appears is a great untold secret: Nutrition is emerging as the most important way to prevent breast cancer.
Deborah McCurdy is a firm believer: "What we eat is such a big part of our lives, there just has to be some effect from what we eat on how we get sick. It seems so logical."
Deborah is trying to prevent a recurrence through a unique breast cancer prevention diet at UCLA. As it does for every woman interviewed for this book, a breast cancer diet gives Deborah a remarkable sense of finally being in charge: "l laving a sense of control made me feel more positive about my condition. I was able to make a difference and help myself."
Whether you're trying to prevent breast cancer or are a breast cancer survivor, you too can grasp that sense of control and hope that this disease can be prevented and its intensity diminished.
As a medical journalist, I confess that I was unaware that diet played any significant part in breast cancer until I was asked what seemed like a simple question: "How do I prevent breast cancer?" The question came from my wife, chairman of the associates committee at Memorial Sloan-Kettering Cancer Center. She rarely talked about it, but breast cancer had struck her mother at an alarmingly young age. Courtney and I had been through much of the catastrophe with her mother, from the first shock at the small mass on the mammogram, through the false hopes that the cancer would be contained, through the aggressive treatment, a mastectomy, to the new hope after reconstructive surgery, and now the endless, just-below-the-surface anxiety that this cancer could recur at any time.
Her mother is not alone in her anxiety. Courtney has stood powerless under the looming shadow of this dreaded disease wondering ifQor whenQit will strike her. Courtney is at a higher risk for early breast cancer due to her mother's young age when first diagnosed and several other risk factors. In her thirties, she already has annual mammograms. The clock is ticking, and she and I want the answer now. How do you prevent breast cancer?
I tell friends I have one of the most exciting jobs in the world. The greatest thrill is finding cutting-edge research that has immediate benefit in people's lives. Thanks to thousands of incredibly dedicated medical researchers who are willing to share their findings, I have access to critical, often lifesaving information months before it becomes public knowledge. Because nutrition as a means of preventing cancer has been such a neglected field, researchers have been unusually forthcoming-willing to share information that otherwise might take years to reach the public. In pursuing an answer for Courtney, I stumbled onto a quick succession of remarkable findings clearly connecting diet to breast cancer.
The first clue came while I interviewed Dr. John Glaspy of the prestigious UCLA Comprehensive Cancer Center. He had just published a study in the Journal of the National Cancer Institute about diet and breast cancer. John sounded like he had stnuck gold. For many women he had. What he discovered was breathtaking.
Like most breakthroughs, John's work was grounded in basic science. He knew that rats implanted with human breast cancers quickly developed fast-growing tumors when fed a diet heavy in omega-6 fats such as corn oil, safflower oil, and many brands of margarine. He also knew that cancers shrank quickly and dramatically in rats fed omega-3 fats, such as fish oils. Armed with this evidence, he asked a group of breast cancer survivors to ingest large quantities of fish oils.
We all think of preventive efforts as taking many decades to come to fruition. Kids are told "Eat your vegetables." Why? If we were truthful, we'd answer: "So you don't get sick in middle age"?-not the kind of answer that gets much play with a nine-year-old. What Dr. Glaspy found amazed him-dramatic changes in three short months. The actual structure of these women's breasts had changed and had become far more resistant to breast cancer. After hearing his story, I asked John: How do you prevent breast cancer? I could feel his energy and enthusiasm practically lift the telephone receiver out of my hand, despite the distance of nearly three thousand miles. He said that the wrong diet was the major driving factor behind breast cancer in this country. John pointed out that we can learn from studying other cultures. For instance, breast cancer strikes one in forty Asian women compared to one in eight American women. Why? John believes the difference is a hugely beneficial diet. Foods aren't just a small risk factor for breast cancer, they can be nearly the whole game. John continued: The right foods may be the major driving force that curbs the current epidemic, accounting for as much as 75 percent of the risk of breast cancer. I thought about Dr. Glaspy's conversation for weeks afterward. Gee, if the cancer has already begun, isn't it too late to stop it? Sure, I was a big believer in foods as drugs-but drugs that powerful?
My next clue came from Dr. Dean Ornish. He was visiting my NBC office to talk about an amazing new project. Dean had become world-famous for proving the impossible-that heart disease could be not just stopped, it could be reversed. My jaw gradually dropped as he explained his newest quest-reversing cancer. He didn't mean reversing a cancer that was full grown but rather reversing the cancer when it was at its very youngest stages. Could it possibly work? He had preliminary proof which cannot be reported here until it has first appeared in a scientific journal.
Dr. Lilian Thompson from the University of Toronto has provided the most compelling early proof that cancer can be reversed. Her work is just now being prepared for publication. What she has found is that breast cancer size actually decreases with a daily course of flaxseed. Flaxseed is quickly becoming one of the most popular health foods in America and has been called one of the most remarkable healing foods of our time. Flaxseed has two critical parts, flax oil, one of the healthiest fats you can eat, and a special fiber that protects against breast cancer and heart disease. This breakthrough study shows that breast cancer size decreases in the short time period between the diagnosis of breast cancer and surgery. That phenomenon is uncommonly seen even with very powerful chemotherapy. But for food to cause a cancer to shrink, this is a real and remarkable first. That kind of shrinkage may reduce the surgery required from a mastectomy to a lumpectomy. Begun early enough, it might prevent cancer altogether.
That led me to an old friend of mine, Dr. Irwin Rosenberg. He runs the world-famous Jean Mayer Nutrition Center at Tufts University in Boston. I asked him: How can we possibly discover all we need to know about foods that prevent breast cancer now-not ten years from now. It was really a rhetorical question. I didn't honestly expect any answer but the usual-"we'll have to wait until the completion of randomized double-blind controlled trials." Those are the gold standard in medicine. There were a dozen such trials now under way to prove that diet prevented breast cancer, but they were years from completion.
However, I had guessed wrong. That was not Dr. Rosenberg's answer. He said: "Bob, most Americans don't want to wait. We have dozens of terribly promising preventive treatments for which the controlled trials have not been finished. But we have a new way of looking at the problem. It's called evidence-based nutritional analysis."
In his kind and professorial way he carefully explained that by piecing together all of the available data, we might find an answer. He was rapidly assembling a team to look at the available information for a variety of illnesses. I quickly turned to breast cancer, where there was already a wealth of nutritional evidence: from test tubes, animal studies, and human studies to studies on women in countries with low breast cancer rates-you name it. And the results of these studies weren't just a series of isolated facts but were all pieces of a giant jigsaw puzzle that could be put together. Very few pieces were still missing. By prodding researchers in the field, I might see those last few pieces fall into place. Evidence-based medicine, as reported in the Journal of the American Medical Association, involves "integrating current best evidence." Evidence-based nutritional analysis is why thousands of American women are already on a breast cancer prevention diet, women like Kathy Owens who have volunteered to be part of this brave experiment. Says Kathy, "I had the opportunity to work with scientists, people who actually know what works. It was a chance to help myself and to help other people. After you've had breast cancer, you want to help yourself; but you also want to help others, so they don't have to go through what you did. You get to help in some way by being in this study. It's a chance to give back, at the same time helping yourself become healthier."
Her physicians have integrated the very best from literally thousands of first-rate scientific papers on breast cancer. Taking a cue from Dr. Rosenberg, I understood that women didn't have to wait for all these long-range studies to be completed. Kathy could make a bet with the odds greatly in her favor that modifying her diet would go a long way to preventing a recurrence of breast cancer. "I was in a really negative situation, having breast cancer; but this is something positive that's come out of it. I've changed my diet, taken steps to help myself. It works. The study showed that and I know I feel better. I have some control again over my life."
The breast cancer prevention diet presented here will integrate all of the latest and most vital research for you into a diet that could save your life. I'm asking you to bet that this diet can play a large part in decreasing your risk of developing breast cancer or, if you already have breast cancer, preventing a recurrence. This is not a bet made on blind faith. It's a bet made on a sound analysis of all the current nutritional research. How good a bet is it? How safe a bet is it? Is it a bet you should make? Here's the case for making the bet today.
THE BREAST CANCER PREVENTION PILL WORKS
In April 1998, in a breathtaking discovery, the National Cancer Institute reported that high-risk women who took the drug tamoxifen decreased their risk of breast cancer by 45 percent. Tamoxifen diminishes the effect of estrogen, the chief fuel for breast cancer growth, by blocking the estrogen receptor-the key principle of the breast cancer prevention diet. For some very high-risk women, the breast cancer prevention pill will be an appropriate measure at the proper age, as we'll see in Part Three of this book. But for most women, the breast cancer prevention diet offers the benefits of medication but none of the risks, such as those of blood clots or uterine cancer. The breast cancer prevention pills, tamoxifen and raloxifene, are described at length in the chapter "Step 1: Block the Estrogen Receptor."
IT'S A BET BEING MADE WITH HARD CASH
Tens of millions of dollars are being spent on divining the nutritional secrets of breast cancer. Research dollars are invested incredibly conservatively. There must be milestones at every step of the way that show progress is being made-and it is in spades. Every piece of evidence points to a strong nutritional role-from studies of women in foreign countries with low breast cancer rates to studies of animals, test tubes, and humans. If the trail had turned cold at any step along the way, the cash would have turned off. It hasn't.
INTERMEDIATE POINTS ARE KNOWN
Researchers look for "end points" in clinical trials. For breast cancer those end points would be fewer cases of cancer, fewer cancer deaths, less spread of the disease. Most studies are not that far along. There are, however, what are called intermediate end points. We can use these intermediate end points to evaluate the benefits of the diet; and the diet has already proved to be effective-it changes the breast's composition, and in some cases decreases the size of an already existent breast cancer. YOU CAN'T AFFORD TO WAIT The fully tested breast cancer prevention diet is a decade away. Why? Human nutritional trials take a very long time to do. For conclusive results, at least 1,000 women at very high risk would have to be studied for five years or longer. And the government won't fund most studies that don't concentrate on one single change, such as a low-fat diet. That means, at the end of those five years, there would be proof that only a single ingredient or nutritional concept worked, such as soy protein or fruits or vegetables. That's why constructing an entire program now makes so much sense. The breast cancer prevention diet provides an ideal framework with which to observe and incorporate changes in your diet as they are reported. HEALTHIER BREASTS Clear healthful fluid courses through the milk ducts of a healthy breast, capable of withstanding the insults of toxic foods and chemicals in our environment. However, in women who smoke or eat a high-fat diet that fluid turns dark and may contain toxins that increase the risk of cancer. THIS IS AN EPIDEMIC, AND IT MAY ONLY GET WORSE Since 1940 there has been a 1 percent increase per year in the rate of breast cancer. This epidemic is not just American, it is evident throughout the world and is increasing from Japan to Africa. In fact, breast cancer is the most common cause of cancer death for women worldwide. That means that your risk may continue to increase. The National Cancer Institute reports that there is no evidence of an epidemic. However, an epidemic is defined as an unacceptably high level by current world standards. In the case of breast cancer, rates are up to ten times higher in the United States than in Far Eastern countries. IT WORKS FOR BILLIONS OF OTHER WOMEN In the United States, out of 100,000 women, 30 to 40 are expected to die of breast cancer. In Thailand and Sri Lanka, that number is an astonishing 2 to 5! You could make the argument that the difference in numbers is due to genetic differences, but it isn't. When Asian women move to the United States, they and their daughters suffer an increased risk of breast cancer close to that of American women. When women move from countries with a high breast cancer risk to that of a lower one, their risk declines as well. It is diet and physical activity that protect billions of women in Japan, China, Korea, Thailand, and Africa. YOU CANNOT ERR WITH A HEALTHY DIET One could argue that a wait-and-see attitude would be prudent. That would be true if there were substantial risks in such a diet. However, the major error you would be making would be toward a much healthier all-around diet. The nutrients in the breast cancer prevention diet have been widely shown to prevent a host of other diseases, from heart attack and stroke to other major cancers, diabetes, and obesity. You can only improve your health. IT'S A BET MADE BY THOUSANDS OF AMERICAN WOMEN WITH BREAST CANCER John Glapsy has found the volunteers in his study to be the most dedicated patients he has ever known. Perhaps they've caught his infectious enthusiasm. Perhaps too, it's because his ideas really work. Kathy Owens says doctors "threw the book" at her in the summer of 1995. She underwent chemotherapy, lumpectomy, mastectomy, stem cell transplantation, and radiation therapy. "Tomorrow's my fiftieth birthday," she said when we spoke. "When I was diagnosed, I didn't think I'd be here to see it, so I'm celebrating, and I feel that I'm going to be around for many more because of the things that I'm doing, the changes that I've made." IT BOOSTS THE EFFECTS OF BREAST CANCER PREVENTION DRUGS Even the best estrogen receptor blockers don't entirely prevent breast cancer. The addition of a great diet adds tremendous synergy to decrease even further your risk of cancer. FOOD IS A LOT KINDER TO YOUR BODY THAN DRUGS Drugs strongly interfere at one very specific point in the sequence that causes cancer, and can therefore develop prominent side effects. By changing your diet, you can interrupt many places in the sequence without the toxicity of drugs. With the amazing inspiration of Kathy and Deborah and dozens of other heroic volunteers, I resolved to embark on a journey for my wife. We would spread all the research out on our dining room table like the pieces of a jigsaw puzzle. I would take as long as it took, turn over every last stone and come back to her with an answer. Since that resolution, I have combed the scientific literature from around the world, read thousands of papers, and visited the laboratories of the most prominent scientists at the finest scientific institutions, from Harvard and UCLA to the National Cancer Institute. Courtney and I have experimented with hundreds of different foods and food combinations at home. I have found dazzling new techniques for probing the nutritional secrets of cancer prevention. In the end we have uncovered the key elements of a breast cancer prevention diet. The diet is everything we imagined it could be and more-capable of quickly and effectively changing the actual structure of the breast, capable of changing the flow in the body of hormones that induce breast cancer from the very first day. It's a fun diet with lots of variation and many other benefits, from preventing heart disease and building stronger bones to losing unwanted body fat. But first and foremost it is a diet that will make you feel the best you have ever felt. This diet is carefully designed to lift your mood rather than dump it-as is so common when you're asked to give up the food you love. You'll also find this is a highly satiating diet that will make it far easier to shed unwanted fat. What you will find in the following chapters is a full account of the foods that cause breast cancer and the treasured foods that prevent breast cancer. You'll also find laid out a range of diets:
* a diet for women with high estrogen levels, i.e., those who have not reached menopause
* a diet for women with low estrogen levels, i.e., for those who are past menopause
* a breast cancer survivor's diet
* an intensive intervention program for women at high risk, using several powerful supplements
* dietary guidelines for your daughters; the earlier your children start, the better their chances of entirely avoiding this cancer The breast cancer prevention diet is true primary prevention, but it does not displace secondary prevention-finding tumors at their earliest stages. That means that self-examination and mammography will still play a critical role in cutting your risk of death from breast cancer. (c) 1998 by Robert Arnot "