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• Uncontrolled growth of cells • Cancer is uncontrolled division of cells and the ability of these cells to invade other tissues, either by direct growth into adjacent tissue through invasion or by implantation into distant sites by metastasis. Metastasis is cells are transported through the bloodstream or lymphatic system
A - normal cell division, B - cancer cell division; 1 - apoptosis; 2 - damaged cell. From the National Cancer Institute
Cancer Death Rates .
Two SCHOOLS ON DIET 1. What to do if you have cancer . Dietary means to prevent cancer 2.
What to do if you have cancer http://www.cancer.gov/cancertopics/eatinghints .
Cancer Treatment Might Include • • • • • • surgery radiation therapy Chemotherapy hormone therapy biologic immunotherapy or combination .
3. 8.Treatment CAN Cause Side Effects 1. 11. 7. 9. 10. 5. loss of appetite changes in weight (either losing or gaining weight) sore mouth or throat dry mouth dental and gum problems changes in sense of taste or smell nausea/vomiting diarrhea lactose intolerance constipation fatigue and/or depression . 4. 6. 2.
Side Effects http://www.gov .cancer.
and salt . sugar. vegetables. alcohol. and whole grain breads and cereals.General Nut Recommendations Nutrition recommendations usually stress eating lots of fruits. and cutting back on fat. including a moderate amount of meat and dairy products.
or oil. sauces butter. cream. margarine. • nutrition recommendations for cancer patients suggest that you eat less of certain high. Intestinal tract problems • Especially radiation treatment .fiber foods • aggravate problems such as diarrhea or a sore mouth. and cooked eggs.Cancer Nut Recommendation may be Different • focus on higher calorie protein foods milk. cheese.
eating enough can be a challenge .Goal build strength and withstand the effects treatment. Healthy people generally can eat enough food to get the nutrients During cancer treatment.
asp .com/html/4/T040300.askdrsears.Anti cancer diet http://www.
• Why? Body has limited space • Cancer cells continue to divide and grow and eventually spread. • Cancer cells are forming continuously but cells have mechanism for elimination • Mutations occur usually at cell checkpoints .Cancer • Normal cells grow and divide but there is a checkpoint mechanism to stop continuous growth.
Metastasis • Benign tumors stay in one place – Remove these and you are usually fine .What is Cancer There are two types of tumors: Malignant and Benign • Malignant tumors spread to other areas in the body .
prostate.Different Cancer • Sarcoma – Derived from connective tissue (muscle bone) • Carcinomas– epithelial tissue • lung. . • Leukemia– cancer of the blood or blood producing cells. • Lymphomas.lymphatic system. breast. and colon etc.
There are several risk factors that increase the chance of cancer: • Age.risk increases >50.meaning the cause is unknown. high cholesterol diets may increase risk. .high fat. • Diet.Causes of Cancer 80% are considered sporadic.
• Cancer is the 2nd most common cause of death in the US after heart disease. • Cancer kills 1 out of every 4 Americans. . • The risk of developing cancer can be reduced by changes in a person’s lifestyle.
Heredity Screenings are recommended for high risk families. You are considered high risk if : Several relatives have had cancer or if someone had cancer at a very early age Don’t PANIC YET .
Types of treatment:
• Surgery- 60% of all cancer pts. have some kind of surgery. • Radiation Therapy
– RADIATION KILLS ALL CELLS
– KILLS ALL CELLS
– STRONG IMMUNITY HELPS
NUTRITION AND CANCER
• Emphasis strongly placed on prevention! • Nutritional support of patients with cancer also very important
2005 National Cancer Institute Natural Natural Death Death . Hesse.The Cancer Process Lethal Phenotype Cancer Burden Evolution/ Progression Malignant Transformation Susceptibility Pre-initiation Death Due to Cancer Birth Birth Life Span Reproduced with permission Bradford W.D from HINTS Data Users Meeting January 20-21. Ph.
Ph.Opportunities for Intervention Control its Behavior Death Due to Cancer Avert or Delay its Onset Detect and Eradicate its Presence 2004 Birth Birth 2015 Life Span Reproduced with permission Bradford W.D from HINTS Data Users Meeting January 20-21. 2005 National Cancer Institute Natural Natural Death Death . Hesse.
D from HINTS Data Users Meeting January 20-21. 2005 National Cancer Institute Natural Natural Death Death .Opportunities for Communication •Diet/Exercise •Risk Reduction •Risk Identification •Preventing Metastasis •Early Detection •Informational Control •Maintenance (Chronic) •Informed Rx Decision •Chemoprevention •Access to Treatment Control its Behavior Avert or Delay its Onset Detect and Eradicate its Presence 2004 Birth Birth 2015 Life Span Reproduced with permission Bradford W. Ph. Hesse.
Cell Death? .
A Case of Murder or Suicide • Phytonutrients and cancer prevention? .
lycopene • Green Tea .β-sitosterol • Red Wine -resveratrol • Many others .epigallocatechin 3-gallate • Plant Sterols.Some Plant Compounds can help eliminate cancer cells • Tomatoes .
stop growth of precancerous cells • Antioxidant .Focus • Chemoprevention – Inhibit. retard.
Immune cell regulation • B cells and T cells are sophisticated — and very effective — front-line players in the body's defenses against infectious agents. . as well as against local cells that have acquired or developed a malignancy • B cells are lymphocytes that play a large role in the humoral immune response as opposed to the cellmediated immune response that is governed by T cells. The abbreviation "B" comes from bursa of Fabricius that is an organ in birds in which avian B cells mature.
. and the release of various cytokines in response to an antigen.H and T immunity • Humoral immunity (HIR) is the aspect of immunity that is mediated by secreted antibodies • Cell-mediated immunity is an immune response that does not involve antibodies but activation of macrophages and natural killer cells. the production of antigen-specific cytotoxic T-lymphocytes.
.Cell Death • What happens to cells? Why don’t they keep growing for ever? – Induced Cell Death • Murder or Suicide…. ..
Murder .Necrosis • Characterized by mitochondrial swelling • Rupture of plama membrane .
mutated.Programmed Cell Death .Suicide .Apoptosis • Active and physiological mode of cell death Natural defense mechanism • Remove damaged. infected cells .
Apoptosis…. • Loss of apoptosis control may lead to uncontrolled growth ….cancer • Apoptotic inducing compounds are sought after for chemoprevention strategies • Holy Grail is to Target on Cancer Cells .
Detection • Cell Cycle Analysis -Flow Cytometry • DNA Fragmentation • Cell Staining .
Cell Cycle Analysis .
Cell Cycle Analysis .
“Dr. Kevorkian-Death Complex”
• Ginsenosides • Cell Assisted Suicide
Diet and Cancer Prevention
The American Cancer Society recommends : • 5 or more servings of plant foods • Reduce high fat foods, especially animal sources. • Unclear • But Epidemiology is clear
.Specific Food and Increased Cancer • Fat.the end products of metabolism have been found to be carcinogenic. colorectal. • Alcohol. and breast cancers.has been connected with liver. • Pickled and Smoked Foods.related to cancers of the esophagus and stomach.
Cooking and Cancer • High temperature frying or charcoal BBQ of meats create potentially toxic that have been linked to cancer development in animals .
Diet and Cancer • Some food show protection • Vitamins such as Vit C and E • Phytochemical – Saponins.many in fruits and vegetables. anthocyanins • Antioxidants. . flavinoids. polyphenols.
Diet and Cancer • Dietary Fiber.Insoluble fiber is connected to decreased risk of colon cancer. .
Physical Activity • Obesity • Sedentary lifestyle – Cause of approx 25 % of breast cancers .
Fruits and Veggies • Source of – Phytochemicals – Antioxidants • Recommendation is at least 5 a day – Vary the source • COLOUR is important too! • Pigments that make up the yellows. oranges. caratinoids – Others? . greens and reds are often the cancer fighters – Anthocyanins.
Phytochemicals • • • • • Prevent cancer cells from multiplying Induce apoptosis Prevent cell damage Immune stimulating Lower cholesterol levels • Denis Heber’s Diets – Healthy diet based on a variety of colours .
cachexia .Nutrition & Cancer • Prevention – balanced intake of macro and micro nutrients – intake of non-nutrient factors such as phytochemical – Mindful of cooking and storage methods • Treatment of Patients – complications • Chemotherapy • Non cancer cells destroyed • diarrhea • Wasting .
colorectal • Antioxidants (nutrient and non-nutrient) from foods – colorectal. pancreas. prostate. pancreas. esophagus. stomach. esophagus. breast • Tea (flavonoids) – lung.Dietary Factors Associated with Reduced Cancer Risk • Dietary fiber – colorectal. lung. breast • Vitamin C from foods – oral cavity. cervix. lung. cervix • Folic acid – cervix. colorectal • Vitamin D and calcium – colorectal. breast. stomach • Alpha-tocopherol – lung • Soy isoflavones? – breast .
rectum . esophagus.maybe • Meat (especially charbroiled) – colon and rectumprobable • Salt – stomach. breast. rectum. pharnyx.maybe • Total and Saturated Fat – lung. larnyx.Dietary and Cancer Risk • Alcohol – mouth. colon. liver-convincing – breast. prostatepossible • Sucrose – colon. colon. rectum.
Breast Cancer • Basics • Different types .
S.Nutrition and Breast Cancer • Breast Cancer is the most common invasive cancer in women in the U. • 30% of all new cancers • Breast cancer mortality declining – Early diagnosis – Improvements in treatments • Recurrence major problem • Large body of evidence on the relationship between nutrition and risk .
and lactation • Stimulates cell proliferation in breast tissue – Increases the random risk for genetic errors and malignant phenotypes – Breast cancer is consider a hormone dependant cancer – Nutritional factors that influence hormones throughout lifecyle are suspectived to influence risk for breast cancer – * changes the phenotype without changing the genotype . pregnancy.Mammary carcinogenesis • Multistep process – Accumulation of genetic and epigenetic* changes – Estrogens have a direct effect the mammary gland • Growth. puberty.
• Premenopausal and Posmenopausal – Status may influences treat and diagnosis – Groups are separated during epidemiological data collection .
Nutritional Factors • Early data derived from cross country comparison • Migration studies – Japanese women move to the U. – Rate of adopted culture and regions with higher breast cancer rates – Suggest environmental factors such as diet may play a role in the etiology .S.
Nutrients and Risk • Total dietary fat may ↑ risk – Inconclusive – Cross cultural comparison indicate a strong association between TF and BC – Observational and cohort studies do no show this relationship • Interpretation of epi studies are difficult • Specific fat is also inconclusive • Suggestion of a link may hold true .Diet.
Lab animals • High fat diets ↑ growth ↑ adiposity – Two factors the ~ # and size of tumors • Omega 6 – Promotes tumors compared to Omega 3 – ? Eicosanoid productions. immune response protein kinase C. membrane function – .
Fat and Estrogen • Estrogen levels ↓ with ↓ fat intake • ↑ fat mass ↑ estrogen levels .
74) for Total veggie intake .46 (95% CI 0. carotenoids – Phytochemicals. folate alpha-tochopherol and fiber provided significant protective effects • Odds ratio of 0. lutein + zeaxanthin.Vegetables and BC • Consistent protective effects seen for vegetables and fruit intake on risk for BC – Vit C. dietary fiber – Micronutrients • Post menopausal women – Case control and cohort studies – Dietary beta carotene.28-0. vit C.
91) .S case –control • 3543 cases.34-0.U.56 (95% CI 0. 9406 controls • Carrots and spinach twice a week – Odds ratio of 0.
US. lutein + zeaxanthin.77 (95% CI 0. Vit C and Vit A – Pre menopausal women • ≥ 5 veggies / day relative risk 0. Cohort – 83.581.02) compared to < 2 veggies a day .234 women 2697 have B or 14 years follow up – Inverse association alpha and beta carotene.
org – Carotenoids . Vitamin A. Vitamin D. and many phytochemicals from vegetables and plants have been shown to inhibit grown and induce apoptosis cell death .atcc.Cell Culture Studies • Cultured breast cancer cells isolated from patients – Stored in tissue banks such as ATCC • American Tissue Culture Collection – www.
Apoptosis • Programmed cell death – Cell executes a series of programs the results in the cell committing ‘suicide’ and recycling the cellular components • Evolutionary adaptation to removed damaged or mutated cells • Many cancer cells have mutations preventing apoptosis thus resulting in unchecked growth of damaged cells .
Phytochemical Induction? .
Antioxidants • Theoretically reduce risk for breast cancer by protecting against DNA damage and free radical induced cellular changes • Results are inconclusive .
folate inadequacy promtes DNA strand breaks and hypomethylation of p53 gene – (mutation check point) • Folate may relate to alchol intake – Epid studies from 1980-90s show positive association with alchol and BC – Possible by affecting folate status .Folate • In animals.
Dietary Fibre • May reduce risk for BC • Influence the enterohepatic circulation of estrogen – Get secreted with bile • Lignan – in wheat bran highest binding affinity for estrogen • Case-control and cohort studies – inconclusive .
Soy and Phytoestrogens • Japanese and Chinese – Historically lowest incidence of BC – Soy and phytoestrogens • Hormonal effect? • Bind estrogen receptor weak estrogenic activity • Could be both beneficial or harmful depending .
Breast Cancer Risk and Food .
S. women (n=3430) • >68 inches (172.7 cm) BC risk 50-80% higher than heat ≤ 62 (157 cm) • Why? – Growth factors increase proliferation of mammary stem cells • Don’t worry still inconclusive and doesn’t realate to mortality . European and Asian – Taller increased risk? • U.Anthropometrics and BC Risk • Height and BC risk? – American.
waist: hip ratio – Independent risk factor for premenopausal BC • Abdominal fat ↑ levels of insulin and related growth factors .g.Adiposity and BC • Obesity and risk factor for Postmenopausal BC – Leaner easier to detect a lump thus early detection • Body fat distribution – Visceral obesity – e.
Non-athletes – Non-athletes RR of 1.47) compared to athletes • > 3.Physical Activity and BC • First reported in 1962 – Sedentary office workers ↑ risk compared to physically active • Athletes vs.42.86 (95% CI 1.00-3.27 -0.64) • Why? – Mediate levels of endogenous hours and ovulatory cycles . CI 95% 0.8 hours exercising / week RR 0.
Molecules to Meals .
membrane lipoproteins. and is found primarily in the testis. It also is found in smaller amounts in grapefruit (pink). and papaya(red).gov/prevention/agents. and DNA • • • Source of nex tinformation on the next few slide obtained from NCI http://www. and lung Lycopene is currently considered one of the most efficient carotenoids at protecting against free radicals that damage critical parts of the cell.Lycopene • Lycopene is a plant-derived carotenoid.cancer. watermelon. guava (pink). adrenal glands. public doman . natural red pigment in tomatoes and tomato products such as ketchup and spaghetti sauce. proteins. prostate. Different from anthocyanins as lycopene is water soluble Lycopene is one of the major carotenoids found in human blood and tissues. including lipids. liver. breast. colon.
• Prostate Cancer • lycopene supplements appeared to reduce the uncontrolled growth of prostate cancer cells (proliferation) and restored normal cell turnover (apoptosis and differentiation) in men (n=21).Lycopene Population Studies • people who eat large amounts of foods with lycopene. and colon cancer. lung. have a reduced risk of prostate. such as cooked tomatoes. .
• • • . Resveratrol is also an antioxidant. Resveratrol has been shown to reduce tumor incidence in animals by affecting one or more stages of cancer development. It has been shown to inhibit growth of many types of cancer cells in culture. Resveratrol is a type of polyphenol called a phytoalexin. a protein produced by the body's immune system when it is under attack. It also reduces activation of NF kappa B.polyphenols prevent cancer? • Polyphenols are antioxidant compounds found in the skin and seeds of grapes. This protein affects cancer cell growth and metastasis.. gallic acid and epicatechin. a class of compounds produced as part of a plant's defense system against disease. Research on the antioxidants found in red wine has shown that they may help inhibit the development of certain cancers. Evidence also exists that it can reduce inflammation.. The phenols in red wine include catechin.
It was also seen that men who consumed four or more 4-ounce glasses of red wine per week have a 60 percent lower incidence of the more aggressive types of prostate cancer. Recent evidence from animal studies suggests this anti-inflammatory compound may be an effective chemopreventive agent in three stages of the cancer process: initiation. promotion and progression. Although consumption of large amounts of alcoholic beverages may increase the risk of some cancers.3. there is growing evidence that the health benefits of red wine are related to its nonalcoholic components. • • • . What have red wine studies found? • The cell and animal studies of red wine have examined effects in several cancers including leukemia. However. Research studies published in the International Journal of Cancer show that drinking a glass of red wine a day may cut a man's risk of prostate cancer in half and that the protective effect appears to be strongest against the most aggressive forms of the disease. skin. breast and prostate cancers. studies of the association between red wine consumption and cancer in humans are in their initial stages.
chemically induced tumors were shown to decrease in size in mice that were fed green and black tea (1. and breast cancers among 58. skin and stomach cancer.279 men and 62.Tea? • • In the laboratory tea catechins act as powerful inhibitors of cancer growth – scavenge oxidants before cell injuries occur. It found no link between tea consumption and protection against cancer (4). a study in the Netherlands did not support these findings. It investigated the link between black tea consumption and the subsequent risk of stomach. colorectal. . The study took into account such factors as smoking and overall diet. 2). reduce the incidence and size of chemically induced tumors. In studies of liver. lung.573 women ages 55 to 69. • However. – inhibit the growth of tumor cells.
others do not. and population differences may account for these inconsistencies. 18. • • China. A second study at the Beijing Dental Hospital found consuming 3 grams of tea a day. a precancerous oral plaque (1). or about 2 cups. Likely no harm • .000 men found tea drinkers were about half as likely to develop stomach or esophageal cancer as men who drank little tea. along with the application of a tea extract reduced the size and proliferation of leukoplakia. – Dietary. environmental.human studies and tea • • Antioxidant yes but human studies have been contradictory. even after adjusting for smoking and other health and diet factors (3). Is there a link? You decide. Some epidemiological studies support the claim that drinking tea prevents cancer.
(4) Goldbohm RA. Brants HA. Gao YT. A review of latest research findings on the health promotion properties of tea. JNCI 1996. (3) Sun CL. 23 (9): 1497-1503. Hertog MG. 88 2): 93-100. 1 (3). . BMC Derm 2001. Nutri Biochem 2001. Consumption of black tea and cancer risk: a prospective cohort study. J. 12 (7): 404-421. Ross RK. Urinary tea polyphenols in relation to gastric and esophageal cancers: a prospective study of men in shanghai. Carcin 2002. Joint effects of citrus peel use and black tea intake on risk of squamous cell carcinoma of the skin. Farnworth ER.Tea References • (1) Dufresne CJ. Harris RB. van den Brandt PA. china. Yang CS. Yu MC. (2) Hakim IA. Yuan JM. van Poppel G. Lee MJ.
are found in a number of plants. but soybeans and soy products like tofu and textured vegetable protein are the primary food source.Soy Isoflavones • Soy isoflavonesfrom soybeansuch as genistein and daidzein. .
. • Isoflavones also have been found to have antiangiogenic effects (blocking formation of new blood vessels). and may block the uncontrolled cell growth associated with cancer. • inhibiting the activity of substances in the body that regulate cell division and cell survival (growth factors).How • Isoflavones acts as antioxidants • Isoflavones can act like estrogen in stimulating development and maintenance of female characteristics or they can block cells from using other forms of estrogen.
and prostate cancers than the general (US) population. and glycitein have found them safe for human use. daidzein. endometrial.Results? • people who eat large amounts of soybased products have lower incidences of breast. • soy isoflavone mixtures containing genistein. colon. .
• Some recent studies have raised the concern that genistein might potentially increase the risk of leukemia. Some cancer patients whose chemotherapy drugs inhibited topoisomerase later developed leukemia. • Estrogen dependent cancers and Isoflavones? .Laboratory studies using animals models • soy and isoflavones can be protective against cancer when given during early life but can stimulate response to cancer-causing chemicals when given during fetal development or when circulating levels of estrogen are low (menopause). NCI researchers have completed animal studies on genistein with no adverse effects being seen. because it can inhibit an enzyme (topoisomerase) that protects DNA from mutations.
Antioxidant Supplements • All good? .
net/?p=257 .BAD SCIENCE http://www.badscience.
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