Copyright Country Living"s Healthy Living January/February 1999

CAN BREAST CANCER BE PREVENTED?

If, as someone once wrote, "illness is the nightside of life," then breast cancer is surely one of its scariest nightmares. The oft-repeated statistic that breast cancer will strike one in nine women provokes particular terror—not just because it suggests that it will strike so many of us, or even because there are no certain cures, but because it conveys the randomness with which the disease taps its victims. Even the recently isolated "breast cancer genes" have turned out to account for less than 10 percent of cancer cases, leaving the other 90 percent to strike any one of the rest of us at any time. We live with the quiet assumption that we are largely helpless against this disease.

According to oncologist Mitchell L. Gaynor, M.D., nothing could be further from the truth.

"We don"t have to live with fear," he says. "We can prevent ourselves from getting cancer." Gaynor, 42, is not a soothsayer: He is the director of Medical Oncology and Integrative Medicine at the Strang Cancer Prevention Center in New York City, one of the country"s oldest and most respected cancer research institutes. Gaynor is also an experienced clinician with a thriving practice and was lauded as one of New York s best doctors by New York magazine.

We are sitting in Gaynor"s office, beneath a wall covered with medical citations and degrees, and we are talking about food. His new book, Dr. Gaynor"s Cancer Prevention Program (Kensington, 1998), is all about nutrients, particularly phytonutrients, and their remarkable power to keep us safe from cancer. Written with Jerry Hickey, R.Ph.D, a well-known nutritional chemist, the book is a compendium of hundreds of natural substances that scientists are exploring for anticancer properties.

"The greatest cancer breakthroughs of our time have been accumulating over the past decade," Gaynor says.Why haven"t they made headlines? Because the advances have been not in the realm of treatment, where total success is still elusive in many cases, but in prevention. Indeed, research is proving, says Gaynor, that nutrition is as specific to the prevention of cancer as seat belts are to car accident injuries.

7 cancer-fighting foods

Based on the latest studies and his own work with patients, Gaynor recommends the following foods and supplements as effective at preventing the development of cancerous cells.

cruciferous vegetables, such as broccoli, arugula, cabbage, cauliflower, and kale, which contain a recently isolated substance called Indole-3 carbinol (I3C), are powerful inhibitors of cancer on the cellular level. DC has been found to prevent the development of estrogen-responsive cells and thus helps the body virtually lock out dangerous estrogens. The same chemical has also demonstrated a talent for converting a dangerous form of estrogen, called estradiol, into a potentially helpful one, called estrone.

soy contains isoflavones, including the particularly potent genistein, which act like what"s called "weak estrogen" in the body. This means that genistein molecules can lock into what are known as "estrogen receptors," taking up space otherwise left open for stronger, more harmful estrogens. Soy-rich diets have also been shown to lengthen menstrual cycles (i.e., increase the days between periods) leading to lower estrogen exposure over the course of a lifetime. Ongoing studies indicate that soy might be effective in two additional ways: It may limit the growth of blood vessels to potentially cancerous cells and it may also enhance the curative impact of chemotherapy.

lycopene, the pigment that turns tomatoes, paprika, and watermelon red, is twice as powerful as beta-carotene in its ability to rid the body of free radicals, the unbalanced molecules that can trigger cell abnormalities, which, in turn, can lead to cancer.

herbs, such as rosemary and curcum-in (found in the spice turmeric), boost the body"s immunity against cancer by inhibiting a dangerous substance called cox-2 enzyme.

the polyphenols in green tea proved to be strong inhibitors of cancer in recent studies conducted in China and Japan, reducing risks of lung and esophageal cancer by up to 60 percent. Green tea also contains a significant amount of vitamin C, the antioxidant associated with reduced risk of breast cancer.

omega-3 fatty acids, found in cold-water fish such as salmon, cod, halibut, and mackerel, are believed to prevent cancer by inhibiting certain chemicals called prostaglandins. Some prosta-glandins are thought to promote cancer by suppressing the immune system. What is known for certain is that human populations around the world with diets rich in cold-water fish have a lower incidence of breast and other forms of cancer.

flaxseed oil is the best source in the plant world of beneficial omega-3 fatty acids; it also contains a substance known as alpha-linolenic acid, which has demonstrated protective powers against breast cancer.

coenzyme Q10 (CoQ10) is an enzyme antioxidant that is naturally produced by the body. Taken as a supplement, it has been found in small-scale studies to reduce breast-cancer risk and may prolong the lives of breast cancer patients.


why aren"t you eating the breas cancer prevention diet?

Clearly the research is in. So why aren"t more doctors urging their patients to eat these cancer-fighting foods? Gaynor believes that most of the medical community hasn"t heard about them. "I went to a very traditional medical school," he says, referring to his training at the University of Texas Southwestern Medical Center, "and nutrition was never mentioned." Gaynor himself knew next to nothing about the role food played in cancer until he worked with molecular biologists in a Rockefeller University research laboratory in New York City after medical school. "My eyes were opened up to a whole new world where it was possible to see the way nutrients affect genes," Gaynor says. "I came to realize that certain chemicals could turn cancer genes on or off."

While the evidence he was finding in the lab was persuasive, he recalls,"no one was actually translating nutrition into cancer prevention." Why not? Because scientists, not doctors, were reading most of the studies, he says. So when he left research to begin working with patients, Gaynor vowed to do what he could to keep the channel open between what scientists learned about nutrition in their labs and what doctors were doing in clinical oncology.

To be sure, as the epidemiological and molecular biological data have accumulated over the past 10 years, more and more doctors have learned about the potential power of foods such as soy and curcumin.

Marisa Weiss, M.D., a Philadelphia-area radiation oncologist and primary-care doctor for breast cancer survivors believes that "nutrition has been ignored for way too long." In her book, Living Beyond Cancer (Random House, 1998), and in her practice, she urges women to stick to a largely vegetarian diet, eat soy, and limit alcohol consumption in their quest to ward off cancer. But, unlike Gaynor, she keeps her recommendations fairly general. "The studies are promising," Weiss allows,"but we don"t have complete proof yet." Indeed, according to the National Cancer Institute itself, clinical prevention studies involve thousands of subjects and can take up to 10 years or more for definitive results.The question for many is, why wait?

Gaynor certainly hasn"t. Most of the patients who visit his office are battling cancer - or its recurrence. A few of them come to him through Strang"s innovative cancer-prevention program, called CANScreen, hoping to learn how they can avoid cancer in the future even though they may be at very high risk. Along with standard medical cancer treatments, such as chemotherapy and radiation, Gaynor regularly prescribes a comprehensive regime of foods and supplements. He and his staff maintain they consistently see progress in patients who follow his prescription, and only sporadically in those who don"t.

Gaynor is the first to admit that it isn"t easy to overhaul a diet that you and your family have grown used to. Neither is it very convenient to take up to 30 different supplements a day. "Patient compliance," he concedes, "could be terrible." For that reason, he and coauthor Hickey formulated a powder called Theragreens containing most of the phytonutrients he prescribes both in his practice and in the book.

And these foods aren"t just for Gaynor"s patients. As we sit talking in his office, before his next appointment Gaynor downs his breakfast: several heaping tablespoons of Theragreens powder mixed in a bottle of Arizona Iced Tea followed by a string of additional supplements, including 100 milligrams of DHA (the active component of omega-3 fatty acids), 1,000 milligrams of evening primrose, 800 IU of vitamin E, 200 micrograms of selenium, 300 milligrams of borage, 120 milligrams of Ginkgo biloba, and 200 milligrams of CoQ10. Altogether, breakfast is over in about six minutes—just about the time it might take any other busy New Yorker to consume a bagel with cream cheese.

At $60 for a 45-day supply, Theragreens (which (continued on page 117) can be ordered through Hickey Chemists at 800-724-5566) isn"t cheap. Nor is it tasty, according to one patient who confesses that she just can"t stomach the powder. "What flavor do you have?" Gaynor asks."I think I have the ick flavor," she says, making a face. Gaynor and Hickey spent months taste testing Theragreens and recently came up with a pineapple flavor that was so popular among patients, it went out of stock within months. While Hickey concurs with Gaynor that patients should eat six to eight servings of fruits and vegetables daily, "practically speaking most people can"t do this without supplements," he adds.


the power of the spirit

"We know now that diet is probably the single biggest influence on cancer," says Gaynor, "but that doesn"t mean that it works alone." The other parts of the cancer-defense equation—physical exercise and stress—are also extremely important to preventing the disease.

"There are hundreds of studies documenting the way stress, depression, and pessimism affect every aspect of the immune system," says Gaynor. "And we

"We can prevent ourselves from getting cancer," Gaynor says.

know that our immune system is our greatest defense against cancer." So finding ways to battle the daily tension and stress that we all face in our lives is essential, he contends.

Gaynor urges anyone serious about reducing cancer risk to learn more about techniques such as sound therapy, yoga, meditation, or qi gong. These can also help us connect to what Gaynor calls our "essence," or inner spirit. "The more we distance ourselves from the essence, the more prone we are to illness," he writes in an earlier book, Healing Essence (Kodansha, 1995). Gaynor himself has long been a student of Eastern philosophies and religions and is continually exploring how various cultures relate the body to the soul.

"I think there is great validity in Chinese medicine and the idea of chi as the energy force that flows through the body creating harmony," says Gaynor. In his biweekly support groups for cancer patients and survivors, he often tells members that "disease is disharmony." This doesn"t mean that we should feel that we cause our own illness, he says— but neither can we neglect our bodies or live with ongoing stress and not expect it to impact our health in some aspect. "The way we live our lives today is an absolute predictor of our future health," Gaynor says, "and we need to take full responsibility."