Lifestyle and Lifestyle and Cancer:Cancer:

Lifestyle and Lifestyle and Cancer:Cancer:Chris Lewis, M.D.Chris Lewis, M.D.

Lela Lewis, M.D., M.P.H.Lela Lewis, M.D., M.P.H.

Lifestyle and Lifestyle and Cancer:Cancer:

What can be done?What can be done?Chris Lewis, M.D.Chris Lewis, M.D.

Lela Lewis, M.D., M.P.H.Lela Lewis, M.D., M.P.H.

NOTE:NOTE:

CAUTION: These talks are for your CAUTION: These talks are for your information only and do not serve to information only and do not serve to create a doctor-patient relationship, if you create a doctor-patient relationship, if you are ill or on medication and wish to are ill or on medication and wish to significantly change your lifestyle you significantly change your lifestyle you should do so under the direction of your should do so under the direction of your regular physician.regular physician.

OUTLINEOUTLINE

1.1. Briefly review pathogenetic factors in Briefly review pathogenetic factors in oncogenesis. oncogenesis.

2.2. Describe the influence of lifestyle on Describe the influence of lifestyle on cancer incidence. cancer incidence.

3.3. Explore lifestyle's impact on cancer Explore lifestyle's impact on cancer survival.survival.

StatisticsStatistics

As of January 2005, cancer deaths As of January 2005, cancer deaths outnumbered deaths from heart diseaseoutnumbered deaths from heart disease In individuals less than 85yoIn individuals less than 85yo

476,009 cancer deaths476,009 cancer deaths 450,637 deaths from heart disease450,637 deaths from heart disease

American Cancer Society. Cancer Statistics 2005. Available at: American Cancer Society. Cancer Statistics 2005. Available at: http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.ahttp://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.asp?sitearea=MEDsp?sitearea=MED. Accessed January 2005.. Accessed January 2005.

StatisticsStatistics

Estimated 1,372,910 new diagnoses of Estimated 1,372,910 new diagnoses of cancer last year, and 570,260 deaths cancer last year, and 570,260 deaths from cancer.from cancer.

American Cancer Society. Cancer Statistics 2005. Available at: American Cancer Society. Cancer Statistics 2005. Available at: http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.ahttp://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.asp?sitearea=MEDsp?sitearea=MED. Accessed January 2005.. Accessed January 2005.

Cancer DeathsCancer Deaths

WomenWomen MenMen

LungLung

BreastBreast Colon and RectumColon and Rectum

Colon and RectumColon and Rectum ProstateProstate

PancreasPancreas

2006 Estimated US Cancer Deaths*2006 Estimated US Cancer Deaths*

ONS=Other nervous system.Source: American Cancer Society, 2006.

Men291,270

Women273,560

26%26% Lung & bronchusLung & bronchus

15%15% BreastBreast

10%10% Colon & rectumColon & rectum

6%6% PancreasPancreas

6%6% OvaryOvary

4%4% LeukemiaLeukemia

3%3% Non-HodgkinNon-Hodgkin lymphoma lymphoma

3%3% Uterine corpusUterine corpus

2%2% Multiple myelomaMultiple myeloma

2%2% Brain/ONSBrain/ONS

23% All other sites23% All other sites

Lung & bronchus 31%

Colon & rectum 10%

Prostate 9%

Pancreas 6%

Leukemia 4%

Liver & intrahepatic 4%bile duct

Esophagus 4%

Non-Hodgkin 3% lymphoma

Urinary bladder 3%

Kidney 3%

All other sites 23%

Common CancersCommon CancersLung cancer #1 killer: Lung cancer #1 killer: 163,500 estimated deaths for 2005.163,500 estimated deaths for 2005.

Prostate Cancer most common cancer in men:Prostate Cancer most common cancer in men: >232,000 men are expected to be diagnosed with >232,000 men are expected to be diagnosed with

prostate cancerprostate cancer

Breast cancer most common cancer in women:Breast cancer most common cancer in women: >211,000 women are expected to be diagnosed with >211,000 women are expected to be diagnosed with

breast cancer this year.breast cancer this year.

American Cancer Society. Cancer Statistics 2005. Available at: American Cancer Society. Cancer Statistics 2005. Available at: http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.asp?sitearea=MEDhttp://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.asp?sitearea=MED . . Accessed January 2005.Accessed January 2005.

Cancer TrendsCancer Trends

Prostate and female breast cancer rates have Prostate and female breast cancer rates have continued to rise.continued to rise.

Lung cancer incidence in men continues to Lung cancer incidence in men continues to decrease in men.decrease in men.

In women, lung cancer rates have been In women, lung cancer rates have been increasing for past years but are finally leveling increasing for past years but are finally leveling off.off.

Jemal A, et al. CA Cancer J Clin 2005;55:10-30. Cancer Statistics.Jemal A, et al. CA Cancer J Clin 2005;55:10-30. Cancer Statistics.

Cancer Incidence Rates* for Men, Cancer Incidence Rates* for Men, 1975-20021975-2002

*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.

0

50

100

150

200

250

1975 1978 1981 1984 1987 1990 1993 1996 1999 2002

Prostate

Lung

Colon and rectum

Urinary bladder

Non-Hodgkin lymphoma

Rate Per 100,000

Melanoma of the skin

Cancer Incidence Rates* for Cancer Incidence Rates* for Women, 1975-2002Women, 1975-2002

*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.

0

50

100

150

200

250

1975 1978 1981 1984 1987 1990 1993 1996 1999 2002

Colon and rectum

Rate Per 100,000

Breast

Lung

Uterine CorpusOvary

Non-Hodgkin lymphoma

CausesCauses

1/3 of all cancers are related to 1/3 of all cancers are related to smokingsmoking

1/3 of cancers related to poor diet, 1/3 of cancers related to poor diet, lack of exercise, and obesity.lack of exercise, and obesity.

American Cancer Society. Cancer Statistics 2005. Available at: American Cancer Society. Cancer Statistics 2005. Available at: http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_http://www.cancer.org/docroot/MED/content/MED_2_1x_Cancer_Statistics_2005.asp?sitearea=MED2005.asp?sitearea=MED. Accessed January 2005. . Accessed January 2005.

Where does cancer Where does cancer come from?come from?

Physiology:Physiology:The Key to be The Key to be Disease Free!Disease Free!

P53 tumor P53 tumor suppressorsuppressor

Li-Fraumeni SyndromeLi-Fraumeni Syndrome cell cycle cell cycle regulation, regulation, apoptosisapoptosis

brain tumors, brain tumors, sarcomas, sarcomas, leukemia, breast leukemia, breast cancer cancer

APCAPCtumor suppressortumor suppressor

Familial Adenomatous Familial Adenomatous PolyposisPolyposis

signaling through signaling through adhesion adhesion molecules to molecules to nucleusnucleus

colon cancercolon cancer

BRCA1BRCA1tumor suppressor tumor suppressor

Familial Breast Cancer Familial Breast Cancer repair of double repair of double strand breaks by strand breaks by association with association with Rad51 protein Rad51 protein

breast and ovarian breast and ovarian cancer cancer

MSH2 and MLH1 MSH2 and MLH1 tumor suppressorstumor suppressors

Hereditary Nonpolyposis Hereditary Nonpolyposis Colorectal Cancer type 1 Colorectal Cancer type 1 (HNPCC1)(HNPCC1)

DNA mismatch DNA mismatch repair repair

colorectal cancer colorectal cancer

RET proto-RET proto-oncogeneoncogene

Multiple Endocrine Multiple Endocrine Neoplasia Type 2 Neoplasia Type 2

transmembrane transmembrane receptor tyrosine receptor tyrosine kinase for glial-kinase for glial-derived derived neurotrophic neurotrophic factor (GDNF)factor (GDNF)

medullary thyroid medullary thyroid cancer, type 2A cancer, type 2A pheochromocytomapheochromocytoma, mucosal hartoma , mucosal hartoma

Inherited Mutations

Inherited mutationsInherited mutations

The mutation can be passed from The mutation can be passed from generation to generation. generation to generation.

This type of mutation is a major factor for This type of mutation is a major factor for only 5% to 10% of cancers. only 5% to 10% of cancers.

Acquired mutationsAcquired mutations

90-95% of cancers are caused by 90-95% of cancers are caused by acquired mutations. acquired mutations.

These types of mutations, unless they These types of mutations, unless they occur in germ cells, cannot be passed on occur in germ cells, cannot be passed on to one’s children.to one’s children.

The GuardThe Guard

P53 tumor suppressor geneP53 tumor suppressor gene The p53 protein senses DNA damage and can The p53 protein senses DNA damage and can

halt progression of the cell cycle in G1. halt progression of the cell cycle in G1.

The p53 protein is also a key player in apoptosis. The p53 protein is also a key player in apoptosis.

Kimball, JW. Kimball, JW. http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/T/TumorSuppressorGenes.htmhttp://users.rcn.com/jkimball.ma.ultranet/BiologyPages/T/TumorSuppressorGenes.html#p53l#p53 Acquired February, 2005.Acquired February, 2005.

The GuardThe Guard

Both copiesBoth copies of the of the p53p53 gene must be mutated for gene must be mutated for this to fail so mutations in this to fail so mutations in p53p53 are recessive. are recessive.

Cells which contain only mutant versions of the Cells which contain only mutant versions of the protein can live on — potentially developing into a protein can live on — potentially developing into a cancer. cancer.

More than half of all human cancers have More than half of all human cancers have p53p53 mutations and have no functioning p53 mutations and have no functioning p53 proteinprotein..

Kimball, JW. Kimball, JW. http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/T/TumorSuppressorGenes.html#http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/T/TumorSuppressorGenes.html#p53p53 Acquired February, 2005. Acquired February, 2005.

Science 266:1821-1828, Cell Cycle Control and CancerScience 266:1821-1828, Cell Cycle Control and Cancer

DNA DamageDNA Damage

Mutations occur when genes encoding Mutations occur when genes encoding cell cycle controlling proteins are cell cycle controlling proteins are damaged.damaged.

What Damages DNA?What Damages DNA?

Inflammation Leads Inflammation Leads to DNA Mutationto DNA Mutation

Inflammatory cells produce Inflammatory cells produce reactive oxygen and nitrogen reactive oxygen and nitrogen species.species.

Oxidative and nitrative DNA Oxidative and nitrative DNA damage from inflammatory damage from inflammatory processes lead to carcinogenesis.processes lead to carcinogenesis.

Kawanishi S, et al. Biol Chem. 2006 Apr;387(4):365-72. Oxidative Kawanishi S, et al. Biol Chem. 2006 Apr;387(4):365-72. Oxidative and nitrative DNA damage in animals and patients with inflammatory and nitrative DNA damage in animals and patients with inflammatory diseases in relation to inflammation-related carcinogenesis. diseases in relation to inflammation-related carcinogenesis.

Ness RB, et al. J Natl Cancer Inst. 1999 Sep 1;91(17):1459-67. Ness RB, et al. J Natl Cancer Inst. 1999 Sep 1;91(17):1459-67. Possible role of ovarian epithelial inflammation in ovarian Possible role of ovarian epithelial inflammation in ovarian cancer.cancer.

Colon Cancer and Colon Cancer and InflammationInflammation

90% of Colon cancer is due to inflammation 90% of Colon cancer is due to inflammation from:from: Oxidizing free radicals in the diet (e.g. Oxidizing free radicals in the diet (e.g.

heated oil)heated oil) Reactive oxygen and nitrogen molecules Reactive oxygen and nitrogen molecules

(Nitric oxide) from immune cells(Nitric oxide) from immune cells Anything which slows passage of digested Anything which slows passage of digested

food through the colon (low-fiber diet)food through the colon (low-fiber diet) These cause DNA mutations in genes such as These cause DNA mutations in genes such as

p53 and other DNA repair genes resulting p53 and other DNA repair genes resulting ultimately in Cancer.ultimately in Cancer.

Itzkowitz SH and Yio X. Am J Physiol Gastrointest Liver Physiol. Itzkowitz SH and Yio X. Am J Physiol Gastrointest Liver Physiol. 2004 Jul;287(1):G7-17. Inflammation and cancer IV. Colorectal 2004 Jul;287(1):G7-17. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation.cancer in inflammatory bowel disease: the role of inflammation.

Autoimmune Disease Autoimmune Disease and Cancerand Cancer

Autoimmune Inflammatory Bowel Autoimmune Inflammatory Bowel Disease (Crohn’s and Ulcerative Colitis) Disease (Crohn’s and Ulcerative Colitis) is accociated with increased rates of is accociated with increased rates of colon cancer. colon cancer.

Itzkowitz SH and Yio X. Am J Physiol Gastrointest Liver Physiol. 2004 Itzkowitz SH and Yio X. Am J Physiol Gastrointest Liver Physiol. 2004 Jul;287(1):G7-17. Inflammation and cancer IV. Colorectal cancer in inflammatory Jul;287(1):G7-17. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation.bowel disease: the role of inflammation.

Inflammation and Inflammation and Gastric CancerGastric Cancer

Stomach inflammation caused by:Stomach inflammation caused by: Salted foods (>3 gm Na/day)Salted foods (>3 gm Na/day) Pickled foodsPickled foods Smoked foodsSmoked foods A high-fat, low-fiber dietA high-fat, low-fiber dietAll of these are associated with increased All of these are associated with increased

incidence of stomach cancerincidence of stomach cancer

Naylor GM, et al. Naylor GM, et al. Gut. 2006 Apr 7. Gut. 2006 Apr 7. Why does Japan have a high incidence of Why does Japan have a high incidence of gastric cancer? A comparison of gastritis between UK and Japanese gastric cancer? A comparison of gastritis between UK and Japanese patients.patients.

Ernst P. Aliment Pharmacol Ther. 1999 Mar;13 Suppl 1:13-8. Review article: the Ernst P. Aliment Pharmacol Ther. 1999 Mar;13 Suppl 1:13-8. Review article: the role of inflammation in the pathogenesis of gastric cancer.role of inflammation in the pathogenesis of gastric cancer.

Prostate Inflammation Prostate Inflammation and Cancerand Cancer

Prostate inflammation/prostatitis is Prostate inflammation/prostatitis is now known to be linked to prostate now known to be linked to prostate tumorigenesis.tumorigenesis.

Nelson WG, et al. J Urol. 2004 Nov;172(5 Pt 2):S6-11; discussion S11-2. Nelson WG, et al. J Urol. 2004 Nov;172(5 Pt 2):S6-11; discussion S11-2. The role of inflammation in the pathogenesis of prostate cancer.The role of inflammation in the pathogenesis of prostate cancer.

Sugar LM. Can J Urol. 2006 Feb;13 Suppl. Inflammation and prostate Sugar LM. Can J Urol. 2006 Feb;13 Suppl. Inflammation and prostate cancer.cancer.

Inflammation and Inflammation and Ovarian CancerOvarian Cancer

Epidemiologic data relates Epidemiologic data relates pelvic inflammatory disease pelvic inflammatory disease with ovarian cancer. with ovarian cancer.

Ness RB, et al. J Natl Cancer Inst. 1999 Sep 1;91(17):1459-67. Ness RB, et al. J Natl Cancer Inst. 1999 Sep 1;91(17):1459-67. Possible role of Possible role of ovarian epithelial inflammation in ovarian cancer.ovarian epithelial inflammation in ovarian cancer.

Ness RB, et al. Epidemiology. 2000 Mar;11(2):111-7.Ness RB, et al. Epidemiology. 2000 Mar;11(2):111-7.Factors related to inflammation of the ovarian epithelium and risk of ovarian Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer.cancer.

Metabolic Syndrome and Metabolic Syndrome and CancerCancer

Study of 1,800 womenStudy of 1,800 women 57% of total calories from 57% of total calories from

carbohydrates linked to a 220% carbohydrates linked to a 220% increased risk of breast cancerincreased risk of breast cancer

Link discovered between refined Link discovered between refined carbohydrates and breast cancer carbohydrates and breast cancer Secondary to rapid rise in insulin.Secondary to rapid rise in insulin.

High levels of insulin support High levels of insulin support rapid growth of tumors.rapid growth of tumors.

J of Cancer Epidemiology, 2005J of Cancer Epidemiology, 2005

How can we How can we protect our DNA?protect our DNA?

AntioxidantsAntioxidants

Antioxidants protect DNA by neutralizing Antioxidants protect DNA by neutralizing free radicals.free radicals.

Vitamins C, E and beta-carotene are Vitamins C, E and beta-carotene are antioxidants naturally found in fruits, antioxidants naturally found in fruits, grains, nuts and vegetables.grains, nuts and vegetables.

The minerals selenium and zinc:The minerals selenium and zinc: Improve immune function Improve immune function Protect against oxidation and DNA damageProtect against oxidation and DNA damage

A Last Line of A Last Line of Defense:Defense:Natural killer and other immune cells Natural killer and other immune cells fight cancer by targeting and fight cancer by targeting and destroying cells that have destroying cells that have undergone malignant degeneration.undergone malignant degeneration.

What Can We do?What Can We do?

In addition to early cancer detection and In addition to early cancer detection and prompt treatment, what else can be done prompt treatment, what else can be done to help prevent and fight cancer?to help prevent and fight cancer?

If you are If you are tiredtired of of worrying about cancerworrying about cancer

You You want rest . . .want rest . . .

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JESUS says…JESUS says…

““Come unto to me all ye that labor and are Come unto to me all ye that labor and are heavy laden, and I will give you rest.” heavy laden, and I will give you rest.” Matthew 11:28Matthew 11:28Rest to Body, Mind and Soul!Rest to Body, Mind and Soul!

WANT

REST

A T E R

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WANT

REST

I R

tm

WANT

REST

U T R I T I O N

tm

WANT

REST

E M P E R A N C E

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WANT

REST

E S T

tm

WANT

REST

X E R C I S E

tm

WANT

REST

U N S H I N E

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WANT

RESTRUST IN DIVINE POWER

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REMEMBER:REMEMBER:

WaterWater

Dehydration and CancerDehydration and Cancer

Dehydration increases the risk for cancers of Dehydration increases the risk for cancers of the the breast, colon, and urinary tractbreast, colon, and urinary tract..

Decrease risk of cancer by drinking 8 Decrease risk of cancer by drinking 8 glasses of water each day.glasses of water each day. Kleiner SM. J Am Diet Assoc 1999 Apr; 99(4):411. Water: an essential but overlooked Kleiner SM. J Am Diet Assoc 1999 Apr; 99(4):411. Water: an essential but overlooked

nutrient.nutrient. Manz FManz F, and , and Wentz AWentz A Nutr Rev. 2005 Jun;63(6 Pt 2):S2-5. T Nutr Rev. 2005 Jun;63(6 Pt 2):S2-5. The importance of good he importance of good

hydration for the prevention of chronic diseases.hydration for the prevention of chronic diseases.

Fresh AirFresh Air

Air Pollution and Air Pollution and Breast CancerBreast Cancer

Women born in areas of New York with Women born in areas of New York with high concentrations of high concentrations of air pollutionair pollution are are 2.4 times as likely to develop breast 2.4 times as likely to develop breast cancer.cancer.

Bonner MR, et al. Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):53-60. Bonner MR, et al. Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):53-60. Breast cancer risk and exposure in early life to polycyclic aromatic hydrocarbons Breast cancer risk and exposure in early life to polycyclic aromatic hydrocarbons using using total suspended particulates as a proxy measure.total suspended particulates as a proxy measure.

Air Pollution and Throat Air Pollution and Throat CancerCancer

Ozone,Ozone, a common air a common air pollutant, significantly pollutant, significantly increases increases laryngeal laryngeal cancercancer..

Pereira FA, et al. J Air Waste Manag Pereira FA, et al. J Air Waste Manag Assoc. 2005 Jan;55(1):83-7. Influence of Assoc. 2005 Jan;55(1):83-7. Influence of air pollution on the incidence of air pollution on the incidence of respiratory tract neoplasm.respiratory tract neoplasm.

Air Pollution and CancerAir Pollution and Cancer

DieselDiesel exhaust stimulates increased exhaust stimulates increased concentrations of cytokines.concentrations of cytokines. Results in Results in inflammationinflammation Ultimately results Ultimately results in DNA damage and in DNA damage and

lung cancer.lung cancer.

Mutat Res. 2004 Aug 8;562(1-2Mutat Res. 2004 Aug 8;562(1-2):119-31. Inflammatory and genotoxic effects of ):119-31. Inflammatory and genotoxic effects of diesel particles in vitro and in vivo.diesel particles in vitro and in vivo.

Fetal Exposure to Diesel Fetal Exposure to Diesel Exhaust Causes CancerExhaust Causes Cancer

Diesel exhaust:Diesel exhaust: Crosses the placentaCrosses the placenta Causes DNA deletions in mice fetusesCauses DNA deletions in mice fetuses Fetal cells divide rapidlyFetal cells divide rapidly RESULT: Increases risk of cancer RESULT: Increases risk of cancer

TAKE HOME POINT:TAKE HOME POINT: Diesel exhaust in Diesel exhaust in utero puts the fetus at risk.utero puts the fetus at risk.

Reliene, R, et al. Mutat Res. 2005 Mar 1;570(2):245-52. Diesel exhaust particles Reliene, R, et al. Mutat Res. 2005 Mar 1;570(2):245-52. Diesel exhaust particles cause increased levels of DNA deletions after transplacental exposure in mice.cause increased levels of DNA deletions after transplacental exposure in mice.

Radon Deaths in USARadon Deaths in USA

U.S. Environgmental Protection Agency. U.S. Environgmental Protection Agency. http://www.epa.gov/iaq/radon/pubs/citguide.htmlhttp://www.epa.gov/iaq/radon/pubs/citguide.html. Obtained 21 March, 2005.. Obtained 21 March, 2005.

* Radon is estimated to cause about 21,000 lung cancer deaths per year, according * Radon is estimated to cause about 21,000 lung cancer deaths per year, according to to EPA's 2003 Assessment of Risks from Radon in Homes (EPA 402-R-03-003)EPA's 2003 Assessment of Risks from Radon in Homes (EPA 402-R-03-003) .  The .  The numbers of deaths from other causes are taken from the Centers for Disease Control numbers of deaths from other causes are taken from the Centers for Disease Control and Prevention's 1999-2001 National Center for Injury Prevention and Control Report and Prevention's 1999-2001 National Center for Injury Prevention and Control Report and 2002 National Safety Council Reports.and 2002 National Safety Council Reports.

Fresh Air in Every Fresh Air in Every Room... To Avoid RadonRoom... To Avoid Radon

Studies show that residential radon is the Studies show that residential radon is the second leading cause of lung cancer death. second leading cause of lung cancer death.

Radon enters the home from the groundRadon enters the home from the ground The principal source of exposure to ionizing The principal source of exposure to ionizing

radiation in most countries.radiation in most countries.

1.1. Pershagen G N Engl J Med. 1994 Jan 20;330(3):159-64. Residential radon Pershagen G N Engl J Med. 1994 Jan 20;330(3):159-64. Residential radon exposure and lung cancer in Sweden.exposure and lung cancer in Sweden.

2.2. Lubin JH, et al. Int J Cancer. 2004 Mar;109(1):132-7. Risk of lung cancer and Lubin JH, et al. Int J Cancer. 2004 Mar;109(1):132-7. Risk of lung cancer and residential radon in China: pooled results of two studies.residential radon in China: pooled results of two studies.

3.3. Krewski D, et al. Epidemiology. 2005 Mar;16(2):137-145. Residential Radon and Krewski D, et al. Epidemiology. 2005 Mar;16(2):137-145. Residential Radon and Risk of Lung Cancer: A Combined Analysis of 7 North American Case-Control Risk of Lung Cancer: A Combined Analysis of 7 North American Case-Control Studies.Studies.

Take-home Points:Take-home Points:

RID YOUR HOUSE OF RADON and RID YOUR HOUSE OF RADON and Air PollutionAir Pollution

1.1. As far as possible get fresh airAs far as possible get fresh air

2.2. Every room in the house should have Every room in the house should have fresh air.fresh air.

Open your windowsOpen your windows Walk in open, fresh airWalk in open, fresh air

NutritionNutritionNutrition

Western Diet increases Western Diet increases Breast CancerBreast Cancer

Asian countriesAsian countries, such as Japan, have low , such as Japan, have low rates of rates of breast cancerbreast cancer, while Western , while Western countries have breast cancer rates that are countries have breast cancer rates that are many times higher. many times higher.

When Japanese girls are raised on When Japanese girls are raised on westernized diets, their rate of westernized diets, their rate of breast cancer breast cancer increases dramatically.increases dramatically.

Armstrong B, Doll R. Int J Cancer 1975;15:617-31.Armstrong B, Doll R. Int J Cancer 1975;15:617-31.Environmental factors and cancer incidence and mortality in different countries, with special Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. reference to dietary practices.

Hirayama T. Prev Med 1978;7:173-95. Epidemiology of breast cancer with special reference to the Hirayama T. Prev Med 1978;7:173-95. Epidemiology of breast cancer with special reference to the role of diet.role of diet.

McCann SE, et al. Int J Cancer. 2004 Sep 1;111(3):440-3. Dietary lignan intakes and risk of pre- McCann SE, et al. Int J Cancer. 2004 Sep 1;111(3):440-3. Dietary lignan intakes and risk of pre- and postmenopausal breast cancer.and postmenopausal breast cancer.

Freudenheim JL, et al. J Natl Cancer Inst. 1996 Mar 20;88(6):340-8. Premenopausal breast cancer Freudenheim JL, et al. J Natl Cancer Inst. 1996 Mar 20;88(6):340-8. Premenopausal breast cancer risk and intake of vegetables, fruits, and related nutrients.risk and intake of vegetables, fruits, and related nutrients.

Creton S, et al. Toxicol Sci. 2005 Jan 5. A mechanistic basis for the role of cycle arrest in the Creton S, et al. Toxicol Sci. 2005 Jan 5. A mechanistic basis for the role of cycle arrest in the genetic toxicology of the dietary carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIPgenetic toxicology of the dietary carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP

Weisburger JH. J Am Diet Assoc. 1997 Jul;97(7 Suppl):S16-23. Weisburger JH. J Am Diet Assoc. 1997 Jul;97(7 Suppl):S16-23. Dietary fat and risk of chronic Dietary fat and risk of chronic disease: mechanistic insights from experimental studies.disease: mechanistic insights from experimental studies.

High Fat Diet Increases Risk High Fat Diet Increases Risk for Most Common Cancersfor Most Common Cancers

1.1. High dietaryHigh dietary fat fat increases the increases the risk of risk of prostate cancerprostate cancer

2.2. Diets high in Diets high in animal fatanimal fat significantly increases the risk significantly increases the risk for for breast cancerbreast cancer. .

Fleshner, N., et.al. Fleshner, N., et.al. Dietary Fat and Prostate Cancer. Dietary Fat and Prostate Cancer. Journal of Urology. 6/11/2004Journal of Urology. 6/11/2004

Armstrong B, and Doll R. Int J Cancer 1975;15:617-Armstrong B, and Doll R. Int J Cancer 1975;15:617-31. Environmental factors and cancer incidence and 31. Environmental factors and cancer incidence and mortality in different countries, with special reference mortality in different countries, with special reference to dietary practices. to dietary practices.

Dietary fat and mammary carcinogenesis. Rose DP, Dietary fat and mammary carcinogenesis. Rose DP, et al. International comparisons of mortality rates for et al. International comparisons of mortality rates for cancer of the breast, ovary, prostate, and colon, and cancer of the breast, ovary, prostate, and colon, and per capita food consumption. Cancer 1986;58:2363-per capita food consumption. Cancer 1986;58:2363-71.71.

Help your body fight cancerHelp your body fight cancer with awith a

Low Saturated Fat DietLow Saturated Fat DietIn post-menopausal women, the higher the In post-menopausal women, the higher the saturated fat in the diet:saturated fat in the diet: The The shorter the breast cancer survivalshorter the breast cancer survival The higher the The higher the rate of metastasisrate of metastasis

Take Home PointTake Home Point: Improve Cancer : Improve Cancer Survival by Survival by decreasingdecreasing dietary fat. dietary fat.Verreault R, Brisson J, Deschenes L, Naud F, Meyer F, Belanger L. Dietary fat in relation Verreault R, Brisson J, Deschenes L, Naud F, Meyer F, Belanger L. Dietary fat in relation

to prognostic indicators in breast cancer. to prognostic indicators in breast cancer. J Natl Cancer InstJ Natl Cancer Inst 1988;80:819-25. 1988;80:819-25.Jaiswal McEligot A, et al. Jaiswal McEligot A, et al. Nutr CancerNutr Cancer. 2006;55(2):132-40. Dietary fat, fiber, vegetable, . 2006;55(2):132-40. Dietary fat, fiber, vegetable, and micronutrients are associated with overall survival in postmenopausal women and micronutrients are associated with overall survival in postmenopausal women diagnosed with breast cancer.diagnosed with breast cancer.

Help your body fight cancerHelp your body fight cancer with awith a

High-fiber, Vegetable-rich DietHigh-fiber, Vegetable-rich DietIn post-menopausal women, the higher the In post-menopausal women, the higher the

fiber and vegetable content:fiber and vegetable content: The The longerlonger the breast cancer survival the breast cancer survival

Take Home PointTake Home Point: Improve Cancer : Improve Cancer Survival by Survival by increasingincreasing dietary dietary vegies.vegies.

Jaiswal McEligot A, et al. Jaiswal McEligot A, et al. Nutr CancerNutr Cancer. 2006;55(2):132-40. Dietary fat, fiber, . 2006;55(2):132-40. Dietary fat, fiber, vegetable, and micronutrients are associated with overall survival in vegetable, and micronutrients are associated with overall survival in postmenopausal women diagnosed with breast cancer.postmenopausal women diagnosed with breast cancer.

Help your body fight cancerHelp your body fight cancer by by Losing weight Losing weight

while eating a low-fat dietwhile eating a low-fat diet Women in the highest tertile of BMI Women in the highest tertile of BMI

had a had a 1.9-fold higher risk1.9-fold higher risk of dying from of dying from their breast cancer compared with those their breast cancer compared with those at the lowest tertile.at the lowest tertile.

2.0-fold higher risk2.0-fold higher risk for the highest tertiles for the highest tertiles of total fat, saturated fat, and of total fat, saturated fat, and monounsaturated fat intake.monounsaturated fat intake.

Zhang S, et al. Zhang S, et al. CancerCancer 1995 Jul 15;76(2):275-83. 1995 Jul 15;76(2):275-83. Better breast cancer survival for Better breast cancer survival for postmenopausal women who are less overweight and eat less fat. The Iowa Women's Health postmenopausal women who are less overweight and eat less fat. The Iowa Women's Health Study.Study.

Good Fats Lower Good Fats Lower Risk of CancerRisk of Cancer

Omega 3-oils prevent cancer.Omega 3-oils prevent cancer. Best source of omega 3 oils:Best source of omega 3 oils:

Flax seed, walnuts, olive oilFlax seed, walnuts, olive oil

Cooking Meat andCooking Meat andCancerCancer

Cooking meatCooking meat produces the dietary produces the dietary carcinogencarcinogen 2-amino-1-methyl-6-2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridinephenylimidazo[4,5-b]pyridine (PhIP). (PhIP).

RESULT: RESULT: Mutates DNAMutates DNA until p53 until p53 overwhelmed.overwhelmed.

FINAL RESULTFINAL RESULT:: ProstateProstate, , Colon Colon and and BBreast reast cancercancer..

Creton S, et al. Toxicol Sci. 2005 Jan 5. A mechanistic basis for the role Creton S, et al. Toxicol Sci. 2005 Jan 5. A mechanistic basis for the role of cycle arrest in the genetic toxicology of the dietary carcinogen 2-amino-of cycle arrest in the genetic toxicology of the dietary carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP).1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP).

Plant Food Plant Food versus Meat versus Meat

Cancers Cancers of the of the coloncolon and and prostateprostate are are nearly nearly 2x as common in non-vegetarians2x as common in non-vegetarians vs. vegetarians. vs. vegetarians.

Frequent Frequent beefbeef consumers also have consumers also have higher risk of higher risk of bladder cancerbladder cancer..

Fraser GE. Fraser GE. Am J Clin NutrAm J Clin Nutr. . 1999 Sep;70(31999 Sep;70(3 Suppl):532S-538S. Associations between diet and Suppl):532S-538S. Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists.Seventh-day Adventists.

Meat Increases risk Meat Increases risk of Colon Cancerof Colon Cancer

A diet rich in A diet rich in meat meat increases increases growth of growth of clostridium bacteriaclostridium bacteria..

Convert primary bile acids to Convert primary bile acids to carcinogenic secondary bile acidscarcinogenic secondary bile acids

RESULT: Higher rates of Colon CancerRESULT: Higher rates of Colon Cancer

1.1. Pai R, et al. Mol Biol Cell. 2004 May;15(5):2156-63. Epub 2004 Mar 5. Deoxycholic acid Pai R, et al. Mol Biol Cell. 2004 May;15(5):2156-63. Epub 2004 Mar 5. Deoxycholic acid activates beta-catenin signaling pathway and increases colon cell cancer growth and activates beta-catenin signaling pathway and increases colon cell cancer growth and invasiveness.invasiveness.

2.2. Kitahara M, et al. Microbiol Immunol. 2001;45(3):263-6. PCR detection method of Kitahara M, et al. Microbiol Immunol. 2001;45(3):263-6. PCR detection method of Clostridium scindens and C. hiranonis in human fecal samples.Clostridium scindens and C. hiranonis in human fecal samples.

3.3. Rastall RA. J Nutr. 2004 Aug;134(8 Suppl):2022S-2026S. Bacteria in the gut: friends and Rastall RA. J Nutr. 2004 Aug;134(8 Suppl):2022S-2026S. Bacteria in the gut: friends and foes and how to alter the balance.foes and how to alter the balance.

FIBER FUN: FIBER FUN:

Fiber speeds the passage Fiber speeds the passage of food through the colon.of food through the colon.

Fiber promotes growth of Fiber promotes growth of healthy gut bacteria healthy gut bacteria Reduces production of Reduces production of

carcinogenic bile acids.carcinogenic bile acids.

World Cancer Research Fund. American Institute of World Cancer Research Fund. American Institute of Cancer Research. Washington, DC: 1997. Food, Cancer Research. Washington, DC: 1997. Food, Nutrition, and the Prevention of Cancer: A Global Nutrition, and the Prevention of Cancer: A Global Perspective.Perspective.

Milk Increases Prostrate Milk Increases Prostrate Cancer RiskCancer Risk

Numerous studies show that:Numerous studies show that: Milk consumption significantly increases Milk consumption significantly increases

the risk of prostate cancerthe risk of prostate cancer

Qin, Li-Qiang, et.al., Qin, Li-Qiang, et.al., Milk Consumption Is a Risk Factor for Prostate Milk Consumption Is a Risk Factor for Prostate Cancer: Meta-Analysis of Case-Control Studies. 5/07/04. JCancer: Meta-Analysis of Case-Control Studies. 5/07/04. Journal: ournal: Nutrition and Cancer. 48 (1): 22-27.Nutrition and Cancer. 48 (1): 22-27.

Soy Milk an Alternative to COWS MILKSoy Milk an Alternative to COWS MILK

Lowers RISK OF PROSTATE Lowers RISK OF PROSTATE CANCER!!!CANCER!!!

Soy Isoflavanoids are antioxidantsSoy Isoflavanoids are antioxidants Soy lowersSoy lowers the risk of the risk of prostate cancerprostate cancer Shown to slow cancer progressionShown to slow cancer progression

““You want me You want me to give up to give up whatwhat?”?”

Legumes and Fruit Legumes and Fruit ProtectiveProtective

Legumes Legumes (peas, lentils, garbanzos (chick peas), kidney (peas, lentils, garbanzos (chick peas), kidney

beans…)beans…) decrease risk of decrease risk of coloncolon and and pancreatic cancerpancreatic cancer..

Fresh and dried fruitFresh and dried fruit lower risk of Lung, lower risk of Lung, Prostate, and Pancreatic cancers.Prostate, and Pancreatic cancers.

Fraser GE. Am J Clin Nutr. 1999 Sep;70(3 Suppl):532S-538S. Fraser GE. Am J Clin Nutr. 1999 Sep;70(3 Suppl):532S-538S. Associations between diet and cancer, ischemic heart disease, Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-and all-cause mortality in non-Hispanic white California Seventh-day Adventists.day Adventists.

Fruits and Vegetables and Fruits and Vegetables and Pancreatic Cancer PreventionPancreatic Cancer Prevention

Prospective cohort of 36,616 women and Prospective cohort of 36,616 women and 45,306 men.45,306 men.

Subjects with the highest amount of dietary Subjects with the highest amount of dietary folate intake were 75% less likely to develop folate intake were 75% less likely to develop pancreatic cancer.pancreatic cancer.

NO benefit from folate suplement or folate-NO benefit from folate suplement or folate-fortified foods!fortified foods!

Journal of the National Cancer Institute 2006;(98):407-413.Journal of the National Cancer Institute 2006;(98):407-413.

Black Beans Black Beans Help Fight CancerHelp Fight Cancer

Chemicals known as tannins found in Chemicals known as tannins found in black-bean inhibit black-bean inhibit colon, breastcolon, breast and and prostate prostate cell proliferation.cell proliferation.

TAKE HOME POINT: Eat your black TAKE HOME POINT: Eat your black beans and FIGHT CANCER GROWTH.beans and FIGHT CANCER GROWTH.

Cancer Lett. 2005 Feb 10;218(2):153-62. Inhibition of Caco-2 colon, MCF-7 and Hs578T Cancer Lett. 2005 Feb 10;218(2):153-62. Inhibition of Caco-2 colon, MCF-7 and Hs578T breast, and DU 145 prostatic cancer cell proliferation by water-soluble black bean breast, and DU 145 prostatic cancer cell proliferation by water-soluble black bean condensed tannins.condensed tannins.

Foods that Fight the Foods that Fight the Growth of Prostate Growth of Prostate CancerCancer

AvocadoAvocado Inhibits prostate cancer cell growthInhibits prostate cancer cell growth

PomegranatesPomegranates Suppress prostate cell growth proliferationSuppress prostate cell growth proliferation

1.1. Qing-Yi, Lu, et.al. Inhibition of prostate cancer cell growth by an Qing-Yi, Lu, et.al. Inhibition of prostate cancer cell growth by an avocado extract: role of lipid-soluble bioactivity. Journal of Nutritional avocado extract: role of lipid-soluble bioactivity. Journal of Nutritional Biochemistry. 16(1). 1/29/05. Biochemistry. 16(1). 1/29/05.

2.2. Pomegranate Extracts Potently Suppress Proliferation, Xenograft Pomegranate Extracts Potently Suppress Proliferation, Xenograft Growth… Journal of Medicinal food. 4/12/2004, 7(3); 274-283.Growth… Journal of Medicinal food. 4/12/2004, 7(3); 274-283.

Antioxidants Lower Risk Antioxidants Lower Risk of Breast Cancerof Breast Cancer

Antioxidants stabilize DNA.Antioxidants stabilize DNA. 5 Servings of 5 Servings of Fruits and VegetablesFruits and Vegetables per per

day lower the risk of day lower the risk of Breast Cancer.Breast Cancer. Best results with fruits and vegetables high Best results with fruits and vegetables high

in Vitamin A and vitamin C.in Vitamin A and vitamin C.

Zhang S, et al. Zhang S, et al. J Natl Cancer InstJ Natl Cancer Inst. 1999 Mar 17; 91(6):547-56. Dietary . 1999 Mar 17; 91(6):547-56. Dietary carotenoids and vitamins A, C, and E and risk of breast cancer.carotenoids and vitamins A, C, and E and risk of breast cancer.

Raw versus CookedRaw versus Cooked

Raw vegetablesRaw vegetables high in antioxidants high in antioxidants vitamin C, folatevitamin C, folate, , β-caroteneβ-carotene, and , and zinczinc decrease risk of breast cancer.decrease risk of breast cancer.

HoweverHowever: Cooked vegetables do not : Cooked vegetables do not protect DNA protect DNA Breast Cancer Breast CancerTake Home PointTake Home Point: : As far as As far as possible eat raw vegetables and possible eat raw vegetables and fruits and LOWER risk of CANCER.fruits and LOWER risk of CANCER.

Adzersen KH, et al. Adzersen KH, et al. Nutr CancerNutr Cancer. 2003;46(2):131-7. Raw and cooked . 2003;46(2):131-7. Raw and cooked vegetables, fruits, selected micronutrients, and breast cancer risk: a case-vegetables, fruits, selected micronutrients, and breast cancer risk: a case-control study in Germany.control study in Germany.

Do Antioxidant Supplements Do Antioxidant Supplements lower the risk of Breast lower the risk of Breast

Cancer?Cancer?NO!NO!

Vitamin A, C, E Vitamin A, C, E supplementssupplements do NOT do NOT prevent breast cancer.prevent breast cancer.

Take Home Point:Take Home Point: Help your body Help your body prevent cancer by using whole prevent cancer by using whole fruits and vegetables.fruits and vegetables.

Freudenheim JL, et al. Freudenheim JL, et al. J Natl Cancer InstJ Natl Cancer Inst. 1996 Mar 20;88(6):340-8. . 1996 Mar 20;88(6):340-8. Premenopausal breast cancer risk and intake of vegetables, fruits, and related Premenopausal breast cancer risk and intake of vegetables, fruits, and related nutrients.nutrients.

Plant Based Diet Plant Based Diet

Lignans are found in plant Lignans are found in plant products.products.

Elevated dietary amounts Elevated dietary amounts associated with lowered risk associated with lowered risk of breast cancer. of breast cancer.

Lignans lower estrogen.Lignans lower estrogen.Take Home Point: Elevated Take Home Point: Elevated lignans prevent breast lignans prevent breast cancercancer..

McCann SE, et al. McCann SE, et al. Int J CancerInt J Cancer. 2004 Sep . 2004 Sep 1;111(3):440-3. Dietary lignan intakes and risk of 1;111(3):440-3. Dietary lignan intakes and risk of pre- and postmenopausal breast cancer.pre- and postmenopausal breast cancer.

Pickling and SpicesPickling and SpicesIncrease the Risk of Increase the Risk of Stomach CancerStomach Cancer

SpicesSpices Pickling with vinegarPickling with vinegar Salt in high quantities > 3g/day increase Salt in high quantities > 3g/day increase

the risk of stomach and intestinal cancerthe risk of stomach and intestinal cancer

Ernst P. Ernst P. Aliment Pharmacol TherAliment Pharmacol Ther. 1999 Mar;13 Suppl 1:13-8. Review . 1999 Mar;13 Suppl 1:13-8. Review article: the role of inflammation in the pathogenesis of gastric cancer.article: the role of inflammation in the pathogenesis of gastric cancer.

Take-home Message:Take-home Message:

The more closely The more closely your diet resembles your diet resembles the original diet in the original diet in Eden, of fresh Eden, of fresh fruits, grains, nuts, fruits, grains, nuts, and vegetables, the and vegetables, the lower your risk of lower your risk of cancer. cancer.

((Genesis 1:29)Genesis 1:29)

TemperanceTemperance

Alcohol is DamagingAlcohol is Damaging

Alcohol increases DNA Alcohol increases DNA mutations: mutations: RESULT: Increased risk of RESULT: Increased risk of

cancer of the lip, mouth, cancer of the lip, mouth, throat, larynx and throat, larynx and esophagus. esophagus.

More than additive risk More than additive risk when combined with when combined with tobacco.tobacco.

National Health and Medical Research Council National Health and Medical Research Council (NHMRC) (2001). (NHMRC) (2001). Australian Alcohol Guidelines: Australian Alcohol Guidelines: Health Risks and BenefitsHealth Risks and Benefits. NHMRC, Canberra.. NHMRC, Canberra.

Alcohol increasesAlcohol increasesLiver CancerLiver Cancer

Alcohol and other causes of Alcohol and other causes of hepatitis increase the risk of hepatitis increase the risk of liver cancer.liver cancer.

O'shea RS, McCullough AJ. O'shea RS, McCullough AJ. Clin Liver DisClin Liver Dis. 2005 . 2005 Feb;9(1):103-34. Treatment of alcoholic hepatitis.Feb;9(1):103-34. Treatment of alcoholic hepatitis.

Alcohol Raises Alcohol Raises Stomach Cancer RiskStomach Cancer Risk

Alcoholic gastritis increases Alcoholic gastritis increases stomach cancer risk.stomach cancer risk.

Xiang Z, Si JM, Huang HD. Xiang Z, Si JM, Huang HD. World J GastroenterolWorld J Gastroenterol. 2004 Nov . 2004 Nov 1;10(21):3212-4. Chronic gastritis rat model and role of 1;10(21):3212-4. Chronic gastritis rat model and role of inducing factors.inducing factors.

Alcohol Causes Alcohol Causes PancreatitisPancreatitis Alcohol is the #1 cause of pancreatitis, a Alcohol is the #1 cause of pancreatitis, a

precursor to pancreatic precursor to pancreatic cancer.cancer. Smoking, alcohol, daily baby aspirin, and a Smoking, alcohol, daily baby aspirin, and a

low folate dietlow folate diet are the only known risk are the only known risk factors for pancreatic cancer.factors for pancreatic cancer. Suspected causes include Suspected causes include physicalphysical inactivityinactivity, ,

pesticide exposure, and refined carbohydrate.pesticide exposure, and refined carbohydrate.

Jura N, et al. Jura N, et al. Cell ResCell Res. 2005 Jan;15(1):72-7. Chronic pancreatitis, pancreatic . 2005 Jan;15(1):72-7. Chronic pancreatitis, pancreatic adenocarcinoma and the black box in-between.adenocarcinoma and the black box in-between.

Michaud DS. Michaud DS. Minerva ChirMinerva Chir. 2004 Apr;59(2):99-111. Epidemiology of . 2004 Apr;59(2):99-111. Epidemiology of pancreatic cancer.pancreatic cancer.

– Schuermhamer, E. A prospective study of ASA use and the risk of pancreatic Schuermhamer, E. A prospective study of ASA use and the risk of pancreatic Cancer in women. Cancer in women. National Cancer instituteNational Cancer institute. 2003; 96;22-28.. 2003; 96;22-28.

Journal of the National Cancer InstituteJournal of the National Cancer Institute 2006;(98):407-413. 2006;(98):407-413.

Women are more Women are more sensitive to alcohol and sensitive to alcohol and

tobaccotobacco Low-to-moderate use of alcohol Low-to-moderate use of alcohol

increases risk of female breast increases risk of female breast cancer.cancer.

TAKE HOME POINT:TAKE HOME POINT: A glass of wine a A glass of wine a day increases breast cancer risk.day increases breast cancer risk.

1.1. National Health and Medical Research Council (NHMRC) (2001). National Health and Medical Research Council (NHMRC) (2001). Australian Alcohol Australian Alcohol Guidelines: Health Risks and BenefitsGuidelines: Health Risks and Benefits. NHMRC, Canberra.. NHMRC, Canberra.

2.2. Alcohol in Australia: Issues and StrategiesAlcohol in Australia: Issues and Strategies . (2001) Commonwealth Department of Health . (2001) Commonwealth Department of Health and Aged Care, Canberra.and Aged Care, Canberra.

3.3. Laslett A, Donath S, and Dietze P (2002). Long term consequences of alcohol Laslett A, Donath S, and Dietze P (2002). Long term consequences of alcohol consumption. In: consumption. In: National Alcohol Research AgendaNational Alcohol Research Agenda. Commonwealth Department of Health . Commonwealth Department of Health and Ageing, Canberra.and Ageing, Canberra.

4.4. Single E, Ashley M, Bondy S, Rankin J and Rehm J (1999). Single E, Ashley M, Bondy S, Rankin J and Rehm J (1999). Evidence Regarding the Level Evidence Regarding the Level of Alcohol Consumption Considered to by Low-Risk for Men and Womenof Alcohol Consumption Considered to by Low-Risk for Men and Women . Commonwealth . Commonwealth Department of Health and Aged Care, Canberra.Department of Health and Aged Care, Canberra.

Alcohol and Breast Alcohol and Breast CancerCancer Women who consume more than 1 Women who consume more than 1

drink per day had 20% higher drink per day had 20% higher circulating estrogen levels compared circulating estrogen levels compared with non-drinkers, which means with non-drinkers, which means higher risk of breast cancer.higher risk of breast cancer.

consumption of fruits, vegetables, consumption of fruits, vegetables, and whole grains showed and whole grains showed inverseinverse associations with androstenedione associations with androstenedione levels.levels.

Maskarinec G, et al. Maskarinec G, et al. Public Health NutrPublic Health Nutr. 2006 Oct;9(7):875-81. Alcohol and dietary fibre . 2006 Oct;9(7):875-81. Alcohol and dietary fibre intakes affect circulating sex hormones among premenopausal women.intakes affect circulating sex hormones among premenopausal women.

Kaaks R, et al. Kaaks R, et al. J Natl Cancer InstJ Natl Cancer Inst. 2005 May 18;97(10):755-65. Serum sex steroids in . 2005 May 18;97(10):755-65. Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation premenopausal women and breast cancer risk within the European Prospective Investigation

into Cancer and Nutrition (EPIC).into Cancer and Nutrition (EPIC).

Tobacco Increases the Risk Tobacco Increases the Risk of the Following Cancers:of the Following Cancers:

LungLung Oral CavityOral Cavity Nasal CavitiesNasal Cavities LarynxLarynx PharynxPharynx EsophagusEsophagus Stomach Stomach LiverLiver

PancreasPancreas KidneyKidney BladderBladder UterineUterine CervixCervix ColonColon Myeloid LeukemiaMyeloid Leukemia

University of Texas M.D. Anderson Cancer Center. http://www.mdanderson.org, acquired 3/05/05.

Short TobaccoShort TobaccoSmoke ExposureSmoke Exposure

Tobacco smoke causes Tobacco smoke causes DNA deletionsDNA deletions Result: CANCERResult: CANCER ONLY ONLY 4 hours of intra-uteri4 hours of intra-uteri cigarette smoke cigarette smoke

increases increases DNA deletions and cancer IN FETUSDNA deletions and cancer IN FETUS Second-hand tobacco smoke causes the same Second-hand tobacco smoke causes the same

cancers as first-hand smoke.cancers as first-hand smoke.TAKE HOME POINT:TAKE HOME POINT: Completely avoid Completely avoid tobacco exposure, especially if pregnant.tobacco exposure, especially if pregnant.

Jalili T, et al. Jalili T, et al. Cancer ResCancer Res. 1998 Jun 15;58(12):2633-8. Cigarette smoke . 1998 Jun 15;58(12):2633-8. Cigarette smoke induces DNA induces DNA deletions in the mouse embryo.deletions in the mouse embryo.

Husgafvel-Pursiainen K. Husgafvel-Pursiainen K. Mutat ResMutat Res. 2004 Nov;567(2-3):427-45. . 2004 Nov;567(2-3):427-45. Genotoxicity of environmental tobacco smoke: a review.Genotoxicity of environmental tobacco smoke: a review.

Caffeine may increase Caffeine may increase risk of carcinogenesisrisk of carcinogenesis

Caffeine appears to Caffeine appears to deregulate cell deregulate cell cycle progression cycle progression allowing cells with allowing cells with mutations to mutations to progress in the cell progress in the cell cycle.cycle.

Qin JQin J, et al. , et al. Anticancer ResAnticancer Res. 2004 Sep-. 2004 Sep-Oct;24(5A):2991-5. Down-regulation of Oct;24(5A):2991-5. Down-regulation of cyclin E expression by caffeine promotes cyclin E expression by caffeine promotes cancer cell entry into the S-phase of the cell cancer cell entry into the S-phase of the cell cycle.cycle.

BMI and Cancer RiskBMI and Cancer Risk

High Body Mass Index (BMI) High Body Mass Index (BMI) raises risk of raises risk of breast cancerbreast cancer..

Central obesity increases Central obesity increases pancreatic cancer.pancreatic cancer.

Patel AV, et al. Patel AV, et al. Cancer Epidemiology Biomarkers PrevCancer Epidemiology Biomarkers Prev. 2005 . 2005 Feb;14(2):459-66. Obesity, recreational physical activity, and risk Feb;14(2):459-66. Obesity, recreational physical activity, and risk of pancreatic cancer in a large u.s. Cohort.of pancreatic cancer in a large u.s. Cohort.

Shu XO, et al. Shu XO, et al. Int J CancerInt J Cancer. 2001 Nov 1;94(3):449-55. Association . 2001 Nov 1;94(3):449-55. Association of body size and fat distribution with risk of breast cancer among of body size and fat distribution with risk of breast cancer among Chinese womenChinese women..

Take-home Message:Take-home Message:

Practice Temperance: Practice Temperance:

Avoid entirely substances harmful to the Avoid entirely substances harmful to the body and use judiciously those things body and use judiciously those things which are beneficial.which are beneficial.

RESULTRESULT: Improved health and cancer : Improved health and cancer prevention.prevention.

RRestest

Regular Sleep Decreases Regular Sleep Decreases CancerCancer

Regular sleep Regular sleep at nightat night decreases decreases risk of risk of breastbreast and and colon cancercolon cancer..

Regular sleep Regular sleep increases melatoninincreases melatonin, , which is which is anti-estrogenicanti-estrogenic Leads to a normal Leads to a normal cortisol cyclecortisol cycle

This helps regulate cancer-fighting natural This helps regulate cancer-fighting natural killer cells.killer cells.

Take Home Point: Improve sleep Take Home Point: Improve sleep habits and lower cancer risk.habits and lower cancer risk.

Stanford University Medical Center.  Stanford University Medical Center.  2003 October2003 October 1: 1: http://http://mednews.stanford.edumednews.stanford.edu. LINK BETWEEN SLEEP, CANCER . LINK BETWEEN SLEEP, CANCER PROGRESSION EXPLORED BY STANFORD RESEARCHERPROGRESSION EXPLORED BY STANFORD RESEARCHER

Get Dark SleepGet Dark Sleep

Being totally blind = 36% lower risk of Being totally blind = 36% lower risk of breast cancer inbreast cancer in women. women.

Early blindness in women is especially Early blindness in women is especially protective against breast cancer (protective against breast cancer (49%49% lower lower risk than sighted women).risk than sighted women).

Nighttime exposure to light interrupts Nighttime exposure to light interrupts melatonin secretion.melatonin secretion.

British Journal of CancerBritish Journal of Cancer March 2001;84:397-399. Sleep In TOTAL Darkness to Decrease March 2001;84:397-399. Sleep In TOTAL Darkness to Decrease Cancer RiskCancer Risk

Sleep in Total Darkness and Sleep in Total Darkness and Male CancerMale Cancer Blind men had a lower incidence of Blind men had a lower incidence of

prostate, stomach, colon, rectum, skin prostate, stomach, colon, rectum, skin and lungand lung cancers. cancers.

Take Home PointTake Home Point: Sleep in total : Sleep in total darkness and decrease cancer darkness and decrease cancer riskrisk

Science News October 17, 1998 154:248-250. Science News October 17, 1998 154:248-250.

Night Shift WorkersNight Shift Workers Nurses Health Study:Nurses Health Study: Irregular hours of sleep in Irregular hours of sleep in

rotating shift workers were rotating shift workers were found to have increased risk of found to have increased risk of breast and colorectal cancer.breast and colorectal cancer.

TAKE HOME POINTTAKE HOME POINT: As far : As far as possible get regular hours as possible get regular hours of sleep.of sleep.

Schernhammer ES, et al. J Natl Cancer Inst. 2001 Oct Schernhammer ES, et al. J Natl Cancer Inst. 2001 Oct 17;93(20):1563-8. Rotating night shifts and risk of breast 17;93(20):1563-8. Rotating night shifts and risk of breast cancer in women participating in the nurses' health study.cancer in women participating in the nurses' health study.Comment in: Comment in:

J J NatlNatl Cancer Inst. 2001 Oct 17;93(20):1513-5. Cancer Inst. 2001 Oct 17;93(20):1513-5. J Natl Cancer Inst. 2002 Apr 3;94(7):530; author reply 532-J Natl Cancer Inst. 2002 Apr 3;94(7):530; author reply 532-

3. 3. J Natl Cancer Inst. 2002 Apr 3;94(7):531-2; author reply J Natl Cancer Inst. 2002 Apr 3;94(7):531-2; author reply

533-4. 533-4. Schernhammer ES, et al. J Natl Cancer Inst. 2003 Jun Schernhammer ES, et al. J Natl Cancer Inst. 2003 Jun

4;95(11):825-8. Night-shift work and risk of colorectal cancer 4;95(11):825-8. Night-shift work and risk of colorectal cancer in the nurses' health study.in the nurses' health study.

Take-home Message:Take-home Message:

GET Regular Sleep at night, GET Regular Sleep at night, without light, and decrease the without light, and decrease the risk of multiple types of risk of multiple types of cancer.cancer.

Exercise

Exercise Lowers Risk of Exercise Lowers Risk of Breast Cancer Breast Cancer

STUDY: 72,608 women STUDY: 72,608 women followed for five years; followed for five years; results showed that results showed that those women who were those women who were most most physically activephysically active had had 29% lower 29% lower incidenceincidence of of breast breast cancercancer..

Patel AV, et al. Cancer Causes Control. 2003 Patel AV, et al. Cancer Causes Control. 2003 Aug;14(6):519-29. Recreational physical Aug;14(6):519-29. Recreational physical activity and risk of postmenopausal breast activity and risk of postmenopausal breast cancer in a large cohort of US women.cancer in a large cohort of US women.

Exercise Lowers Colon Exercise Lowers Colon Cancer RiskCancer Risk

Increasing hours of Increasing hours of exercise exercise directly lowered directly lowered colon cancer colon cancer risk.risk. Exercise decreases inflammation by Exercise decreases inflammation by

lowering prostaglandin E2 levels in lowering prostaglandin E2 levels in colorectal mucosa.colorectal mucosa.

Chao A, et al. Cancer Epidemiol Biomarkers Prev. Chao A, et al. Cancer Epidemiol Biomarkers Prev. 2004 Dec;13(122004 Dec;13(12):2187-95. Amount, type, ):2187-95. Amount, type, and timing of recreational physical activity in relation to colon and rectal cancer in older adults: and timing of recreational physical activity in relation to colon and rectal cancer in older adults: the Cancer Prevention Study II Nutrition Cohort.the Cancer Prevention Study II Nutrition Cohort.

Martinez ME, et al. J Natl Cancer Inst. 1999 Jun 2;91(11):950-3. Physical activity, Martinez ME, et al. J Natl Cancer Inst. 1999 Jun 2;91(11):950-3. Physical activity, body mass index, and prostaglandin E2 levels in rectal mucosa.body mass index, and prostaglandin E2 levels in rectal mucosa.

Non-strenuous Exercise is Non-strenuous Exercise is BestBest

Exercise Exercise need not be need not be strenuousstrenuous in order in order to to see the anti-cancer see the anti-cancer benefit.benefit.

McTiernan A, et al. JAMA. 2003 Sep McTiernan A, et al. JAMA. 2003 Sep 10;290(10):1331-6. Recreational physical activity 10;290(10):1331-6. Recreational physical activity and the risk of breast cancer in postmenopausal and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort women: the Women's Health Initiative Cohort Study.Study.

Knight JAKnight JA , et al. Am J Epidemiol. 2005 Dec , et al. Am J Epidemiol. 2005 Dec 1;162(11):1114-22. Epub 2005 Oct 5. 1;162(11):1114-22. Epub 2005 Oct 5. Light and Light and exercise and melatonin production in women.exercise and melatonin production in women.

Take-home Point:Take-home Point:

Exercise prevents cancer. It should be Exercise prevents cancer. It should be regular but need not be strenuous. regular but need not be strenuous.

Regular, brisk walking is ideal.Regular, brisk walking is ideal.

SunshineSunshineSunshineSunshine

Vitamin D Vitamin D and Sunshineand Sunshine

Sunlight is necessary for the conversion of 7-Sunlight is necessary for the conversion of 7-dehydrocholesterol in the dermis to 25-dehydrocholesterol in the dermis to 25-hydroxycholecalciferol which is, in turn, hydroxycholecalciferol which is, in turn, converted to 1,25-dihydroxycholecalciferol by converted to 1,25-dihydroxycholecalciferol by the kidneys.the kidneys.

Vitamin D Vitamin D PreventsPrevents Cancer Cancer

High levels of Vitamin D are associated with High levels of Vitamin D are associated with increased apoptosis in rectal epithelium.increased apoptosis in rectal epithelium.

Take Home Point: Vitamin D helps the Take Home Point: Vitamin D helps the body rid itself of old or damaged cells so body rid itself of old or damaged cells so that they do not live on to become that they do not live on to become cancercancer..

Miller EA, et al. Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):525-8. Calcium, Miller EA, et al. Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):525-8. Calcium, vitamin d, and apoptosis in the rectal epithelium.vitamin d, and apoptosis in the rectal epithelium.

Sunshine Helps the Sunshine Helps the Body Fight CancerBody Fight Cancer

Vitamin D inhibits Vitamin D inhibits angiogenesis and angiogenesis and adjacent tissue adjacent tissue invasion.invasion.

Lower ratesLower rates of lung of lung cancer cancer metastasismetastasis..

Nakagawa K, et al. Carcinogenesis. 2005 Nakagawa K, et al. Carcinogenesis. 2005 Feb 17;22-oxa-1α,25-dihydroxyvitamin D3 Feb 17;22-oxa-1α,25-dihydroxyvitamin D3 inhibits metastasis and angiogenesis in inhibits metastasis and angiogenesis in lung cancer.lung cancer.

Sunshine Lowers Breast Sunshine Lowers Breast Cancer RiskCancer Risk

Women with a Women with a Vitamin D gene mutationVitamin D gene mutation have have 2X2X the riskthe risk of developing of developing breast breast and and other cancers.other cancers.

BBC News. BBC News. http://news.bbc.co.uk/1/hi/health/3542344.stmhttp://news.bbc.co.uk/1/hi/health/3542344.stm

Vitamin D and Vitamin D and Breast Cancer SurvivalBreast Cancer Survival

Norwegian StudyNorwegian Study Premenopausal women diagnosed with Premenopausal women diagnosed with

breast cancer in the summer had a 15-breast cancer in the summer had a 15-25% lower relative risk of dying from their 25% lower relative risk of dying from their disease compared with those diagnosed disease compared with those diagnosed during the winter.during the winter.

Porojnicu AC, et al. Porojnicu AC, et al. Breast Cancer Res TreatBreast Cancer Res Treat. 2006 Sep 21; Changes in risk of . 2006 Sep 21; Changes in risk of death from breast cancer with season and latitude : Sun exposure and breast death from breast cancer with season and latitude : Sun exposure and breast

cancer survival in Norway.cancer survival in Norway.

Vitamin D and Vitamin D and Breast Cancer SurvivalBreast Cancer Survival

Norwegian StudyNorwegian Study Those living in the southeast region of Those living in the southeast region of

the country with its 1.5X higher annual the country with its 1.5X higher annual UV exposure also had a 25% lower RR UV exposure also had a 25% lower RR of death.of death.

No benefit from Vitamin D food No benefit from Vitamin D food supplement during winter for northerners.supplement during winter for northerners.

Porojnicu AC, et al. Porojnicu AC, et al. Breast Cancer Res TreatBreast Cancer Res Treat. 2006 Sep 21; Changes in risk of . 2006 Sep 21; Changes in risk of death from breast cancer with season and latitude : Sun exposure and breast death from breast cancer with season and latitude : Sun exposure and breast

cancer survival in Norway.cancer survival in Norway.

Sunshine and Sunshine and Prostate CancerProstate Cancer

Vitamin D has been shown to reduce Vitamin D has been shown to reduce cytokine-related inflammation associated cytokine-related inflammation associated with prostate cancer carcinogenesiswith prostate cancer carcinogenesis..

Nonn L, et al. Cancer Res. 2006 Apr 15;66(8):4516-24. Inhibition of p38 by vitamin Nonn L, et al. Cancer Res. 2006 Apr 15;66(8):4516-24. Inhibition of p38 by vitamin D reduces interleukin-6 production in normal prostate cells via mitogen-activated D reduces interleukin-6 production in normal prostate cells via mitogen-activated protein kinase phosphatase 5: implications for prostate cancer prevention by protein kinase phosphatase 5: implications for prostate cancer prevention by vitamin D.vitamin D.

Melatonin and Melatonin and Breast CancerBreast Cancer

Melatonin has been found not only to Melatonin has been found not only to neutralize the effects of estrogensneutralize the effects of estrogens on the on the breast, but also to breast, but also to block the local biosynthesis block the local biosynthesis of estrogensof estrogens from androgens from androgens

Similar effect to estrogen blocking medicationsSimilar effect to estrogen blocking medications

Cos S, et al. Cancer Detect Prev. 2006 Apr 26.Cos S, et al. Cancer Detect Prev. 2006 Apr 26. Estrogen-signaling pathway: A Estrogen-signaling pathway: A link between breast cancer and melatonin oncostatic actions.link between breast cancer and melatonin oncostatic actions.

Melatonin and CancerMelatonin and Cancer

Melatonin helps fight Melatonin helps fight breast and colon breast and colon cancercancer, and possibly , and possibly cancers of the cancers of the prostateprostate, stomach, rectum, skin and , stomach, rectum, skin and lunglung..

Early morning sunlightEarly morning sunlight is particularly is particularly important for increased secretion of important for increased secretion of melatonin secretion at night.melatonin secretion at night.

Sunshine Prescription:Sunshine Prescription:

Medline Plus. Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/article/0http://www.nlm.nih.gov/medlineplus/ency/article/002405.htm.02405.htm. Acquired 3/8/05. Acquired 3/8/05.

Trust in Trust in Divine Divine PowerPower

Mental and Physical Health Mental and Physical Health InteractInteract

1.1. Mental stress raises inflammation:Mental stress raises inflammation:““To balance the immune system, one must To balance the immune system, one must balance the mind and emotions.”balance the mind and emotions.”

2.2. Inflammation increases cancerInflammation increases cancerTake Home PointTake Home Point: Mental imbalane can : Mental imbalane can increase the risk of cancer.increase the risk of cancer.

TAKE HOME POINTTAKE HOME POINT: “A merry heart doeth good like : “A merry heart doeth good like a medicine, but a broken spirit drieth the bones.a medicine, but a broken spirit drieth the bones.

Veldhuijzen. Ann Rheum Dis. Veldhuijzen. Ann Rheum Dis. 2005 Feb 11.2005 Feb 11. Increased C reactive protein in Increased C reactive protein in response to acute stress in patients with rheumatoid arthritis.response to acute stress in patients with rheumatoid arthritis.

Spiritual Health (Faith) Spiritual Health (Faith) Helps the Body Fight CancerHelps the Body Fight Cancer

Self-reported or perceived 'religiousness',Self-reported or perceived 'religiousness', as as defined in the study was associated with a defined in the study was associated with a 30% 30% improvement in cancer survival.improvement in cancer survival.

Take Home Point: Take Home Point: Improved spiritual health Improved spiritual health (trust) helps the body fight cancer.(trust) helps the body fight cancer.

Kune GA, et al. J R Soc Med. 1993 Nov;86(11):645-7. Perceived religiousness is protective for Kune GA, et al. J R Soc Med. 1993 Nov;86(11):645-7. Perceived religiousness is protective for colorectal cancer: data from the Melbourne Colorectal Cancer Study.colorectal cancer: data from the Melbourne Colorectal Cancer Study.

The Perfect TriangleThe Perfect Triangle

Physical, Mental and Spiritual Health Physical, Mental and Spiritual Health work together to create “WHOLE work together to create “WHOLE PERSON HEALTH”PERSON HEALTH”

When one aspect is defective or missing, When one aspect is defective or missing, then the other parts are affected.then the other parts are affected.

““Faith cometh by hearing and hearing Faith cometh by hearing and hearing by the word of God.”by the word of God.”

Romans 10:17Romans 10:17

In summary:In summary:1.1. Healthy choices in lifestyle can exhibit a Healthy choices in lifestyle can exhibit a

great influence to decrease cancer great influence to decrease cancer incidence.incidence.

2.2. Cancer survival can even be affected by Cancer survival can even be affected by healthy changes in diet and lifestyle.healthy changes in diet and lifestyle.

3.3. These principles can be remembered with These principles can be remembered with the acronym, ‘W A N T R E S Ttm’.the acronym, ‘W A N T R E S Ttm’.

And Remember: Health Change is ProgressiveAnd Remember: Health Change is Progressive

NOTE:NOTE:

CAUTION: These talks are for your CAUTION: These talks are for your information only and do not serve to information only and do not serve to create a doctor-patient relationship, if you create a doctor-patient relationship, if you are ill or on medication and wish to are ill or on medication and wish to significantly change your lifestyle you significantly change your lifestyle you should do so under the direction of your should do so under the direction of your regular physician.regular physician.

Copyright 2006. Copyright 2006. Federal law and Christian ethics dictate that no Federal law and Christian ethics dictate that no part of this presentation may be reproduced or part of this presentation may be reproduced or used in any form or by any means, electronic used in any form or by any means, electronic or mechanical, without permission of the or mechanical, without permission of the publishers.publishers.