Reducing Cancer Promoters
One of the largest problems facing people with cancer is the feeling of helplessness because your life is sort of out of your hands, but there are a few things you can do to perhaps have bit more control. Obviously this is touching the surface and only going to go so far, but to me it’s better than sitting back and letting fate happen. After much research in the past few months I compiled an action plan to follow. By research I mean loads of books and hundreds of studies based around lifestyle choices and a few about treatments. But for the most part treatment is out of my hands so I didn’t go to deep into that for long. Although there is up and coming stuff that looks great. Just not ready for general human consumption yet.
I’ve had this action plan for about 6-7 weeks now but decided to post it as a blog post because this blog gets enough views through people searching google about brain tumours that It might help someone else as not everyone would have the time or inclination to bother with all this reading. Its a very simplified list and by no means comprehensive but its just what I am doing at the moment to make the best of a bad situation. I’ll try and reference everything to demonstrate that what I am suggesting is based on research, but for most points there are hundreds of possible articles to site so I’ll normally stick with one for simplicity sake. And I encourage you to read the references and or google search anything you might be interested in. For a lot of you this will all be old news that you have read before.
My 6 targets:
1. Lower igf-1
2. Decrease insulin resistance
3. Decrease inflammation
4. Reduce stress
5. Find the best Surgeon
6. Any alternative therapies you believe in
Lowering blood IGF-1 levels
For those that don’t know igf-1 (insulin like growth factor) is a hormone in the body that increases growth. It is present in all of us at certain levels in our body. It’s extremely high in kids as they are growing because the body needs growth hormones to know when to grow, obviously. Anyway when you become an adult elevated growth hormone levels may not be ideal for health and longevity. Lifestyle choices can have large impacts on levels of igf-1 present in the body. For example prior to diagnosis I did a lot of weightlifting and ate a high animal protein diet in order to grow strong. Little did I know that tumours respond to the same growth hormones as the rest of your body. Well I didn’t know I had a tumour at the time so I don’t blame myself. The point is that IGF-1 is linked with cancer and cancer progression and maybe even lifespan and health in general, many anti-aging studies see this hormone as the cause of aging. It will only take a quick google search to hit thousands of results on this topic. But for the sake of referencing I will use these (Jenkins et al. 2006) and (Baserga et al. 2003)
Fortunately for us, IGF-1 is something we can do something about. I’ve researched a few ways of reducing IGF-1, and if you’ve read any popular nutritional books about health you will probably recognise a few of them. These include the following.
· Reduce protein intake and reduce/remove animal protein from diet
· LISS (low intensity steady state cardio)
· Reduce/remove refined sugars
Reduce/Remove animal protein
This one was hard for me as I was a big meat eater. But I couldn’t ignore the evidence. In most anti-cancer diet books you’ll read the recommendation to reduce red meats etc. but from research done in the china study (2006, Campbell), the worst culprit for increasing igf-1 seems to be dairy proteins. I toyed with the idea of reducing meat intake and cutting out dairy, but in the end I knew I had to go vegan to be happy that I was doing the best I can for myself and my body. The popularity of cancer nutrition books makes me believe that this idea won’t be a new one for most of you living with cancer.
Very recently (March 2014), a study came out in the journal of Cell Metabolism discussing the issue of dietary protein, IGF-1 and cancer/other diseases. The take home points were that high protein intake is linked to increased cancer, diabetes and overall mortality, IGF being the key contributor although higher protein maybe protective of older adults due to less weight-loss. Plant proteins were associated with lower mortality than animal proteins. Adults reporting high protein intakes had a 4fold increase in cancer, but plant proteins were associated with an abolished or attenuated risk (Levine et al. 2014).
Food choices may be a more important factor in reducing IGF 1 than calorie restriction.
"The vegans had significantly less circulating IGF-1, even if they were heavier and had more body fat than meat eaters," he says. "Protein in the diet seemed to correlate with the lower levels of IGF-1. The strict vegans took in about 10 percent of their total calories from protein, whereas those on calorie restriction tended to get about 23 or 24 percent of calories from protein."
(Fontana, 2006, 2008)
Take home point being reduce the meat intake as much as you’re willing to do so.
LISS low intensity steady state cardio
Simply put, low intensity steady state cardio such as walking has been shown to reduce igf-1 levels in humans, not to mention the other benefits of such an activity. A study by Nishida et al. 2010 was performed to understand the link between cardiovascular exercise and its link to reducing cancer. They discovered that cardiovascular exercise below the lactate threshold decreases IGF-1 concentrations in the blood whilst increasing insulin sensitivity and decreasing fasting glucose levels which are all good things for cancer sufferers supposedly but I’ll discuss them more later in the section about sugar.
The national cancer institute http://www.cancer.gov/cancertopics/factsheet/prevention/physicalactivity discusses further benefits of exercise as improving other areas of life such as fatigue, weight gain and improved survival statistics, and psychological well-being over those with low levels of physical activity. This is going to be a lot harder for some than others of course, but do what you can. After surgery I started off walking small distances and as I got my strength back I increased to 10 minutes and then went further and further as i got stronger. I now walk about 12km a day on the treadmill or outside, which takes about a couple hours. But it took me a couple months to build up to that. This is about doing what you feel like you can. I’m not suggesting more is better or anything like that.
In rodent studies calorie reduction in the area of 30-50% percent increased rodent survival by 50% probably due to reduced IGF-1 but this wasn’t the case with humans who seemed to gain no IGF-1 reduction benefit from CR (Fontana, 2006, 2008).
But I am still including it because for reasons not related it still has in impact on brain tumour growth, due to reducing blood glucose levels most likely. At least this made a vast difference in mouse models (Mulrooney et al. 2011.) because this is just mouse models I fully understand if you choose to ignore it. However, there are clinical trials in this method of treatment beginning in the US now.
Refined Sugar + IGF-1
IGF-1 raises in response to high blood sugar and vice versa (Lewitt et al. 1991) although as you probably already know this isn’t the only problem with sugar and cancer.
Decrease insulin resistance
Studies suggest a link a between insulin resistance and cancer although aren’t sure about why (Brunning et al. 1992) (Djiogue et al. 2013). Insulin resistance is a condition where your bodies cells don’t respond to insulin as well as they should leading to hyperglycaemia. As blood sugar increases Insulin raises in the blood to tell your cells to absorb glucose. However in the insulin resistant individuals this doesn’t occur efficiently leading to higher blood glucose levels. It’s perhaps reasonable to presume that this leaves more glucose in your blood free to be used by your cancer cells. If you have read any book about diet and cancer you will know that cancers primarily feed on sugar. So high blood sugar is a bad thing.
Fortunately there are a few things we can do to improve our bodies insulin sensitivity for ourselves, mostly diet and exercise related.
Diet and insulin sensitivity
Eat low glycemic index carbohydrates. If you don’t understand this concept or have never heard of glycemic index I suggest a quick google search, its far too long for a blog post such as this. They have been shown to improve insulin resistance (Frost et al. 1996). An example is eating carbohydrates with their fiber attached to them still. Wholemeal pasta and breads are better than the refined version because they take longer for your body to digest them. Sweet potatoes are better than white potatoes apparently. The highest glycemic foods are things like chocolate and sweets so i don't eat any of that anymore.
Cutting out carbs isn’t essential although, high carbohydrate diets that are high in fiber (tends to mean high amount of plant based foods such as vegetables and beans) are shown to improve peripheral insulin sensitivity (Fukagawa, 1990). This effectively means more of the carbohydrates/sugar you eat is being absorbed by your healthy cells rather than your cancer. A lot of people with brain tumours suppress sugar getting to their cancer by not eating any carbohydrates at all. Which is an approach called the Ketogenic diet which is studied in glioblastomas. However this is an extremely difficult diet to follow and has many drawbacks. Not least because involves over 80% of your diet being pure fat. I’ve tried it and its impossible for me to follow, it made me feel very ill. Ketogenic diets and treatment for brain cancer, are as yet a theory present for glioblastomas. And the ability to use ketones for energy may be present in other Gliomas so would hold no benefit there. Anyway look into it for yourself if you’re interested, but I am not personally recommending it.
My recommendation is eat the right sort of carbohydrates, fiber and all as nature intended.
Exercise and insulin sensitivity
As previously mentioned exercise improves insulin sensitivity as your bodies muscles use more glucose for energy and become better and more efficient at this process even when resting leaving less glucose for cancer to use. This is true for cardiovascular exercise and resistance training such as weightlifting (Shaibi et al. 2006), now wouldn’t it be helpful if there were studies on resistance training and cancer, well there are, but none that I could find on prognosis, although other positive effects were noted such as improved strength during treatment which is self-explanatory really (Strasser et al. 2013). To assume this would affect survival we have to follow a chain of thought. Resistance training increases muscle insulin sensitivity > lower blood glucose> less sugar for cancer growth. That’s a theory anyway. And one I encompass and use.
Inflammation plays a huge role in brain tumours because of the side effects it causes in the brain. but its another common theme in all anti-cancer books, reducing inflammation is important due its cancer effects and maybe even causation. It’s long been suggested that inflammation is a leading cause and component of progression in tumours (Coussens and Werb 2002) (Rakoff-Nahoum 2007). why’s and how’s are interesting but too long winded for this blog post. I’ll instead discuss possible ways of reducing inflammation. This is covered in so many websites and pages I’m debating whether to do a section on this.
The take home points are good diet is essential. High in plant based foods which are high in vitamins, minerals and antioxidants that reduce inflammation (Watzl 2008), and a good balance of omega 3 fatty acids too omega 6 fatty acids, which basically means eat more omega 3s because they reduce inflammation. I supplement mine as it’s hard to find a good reliable source as a vegan. DHA found in fish is the most important omega 3 so find a supplement with a good source of that in.
Junk foods and animal proteins increase inflammation supposedly. There are many anti-cancer books out there that discuss this and more across a whole book rather than a short blog, I encourage any people who haven’t to find and read one of them. Curcumin from turmeric is a supplement that is proven to provide anti-inflammatory benefits.
Stress is bad for the immune system (Sergerstrom and Miller 2004), the immune system is the bodies defence against disease and cancer, the stronger our immunity is the better we are at fighting cancer. That’s great and all, but if you have cancer, not too many things are more stressful. Everyone has their own ways of reducing stress, either avoiding it all together (impossible?) or dealing with it in certain ways. Meditation is commonly used. I sort of drift into a dream world during my long walks and that seems to work effectively to reduce stress for me. Find your own way and stick to it. Exericise is a proven effective way of reducing stress and other mental health issues such as depression and anxiety which are common effects of living with cancer (Salmon 2001). So maybe the positive thinking I do during exercise has no benefit on stress and it’s all down to the exercise. Anyway all of you can find something that relieves stress, whether it be meditation, yoga, prayer or whatever you choose!
Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry
What I am talking about here is relative to low grade brain tumours at least. With regards to gliomas it seems the initial surgery can play a part in the overall prognosis. The extent of the resection has some effects on overall survival, progression free survival and transformation time. By effects I’m talking about years when talking about low grade tumours and months for high grade. In the research patients were divided into gross total resection, near total resection and subtotal resection and then were followed for the rest of their lives. I was going to include the statistics but knowing some people with tumours who read this, I will leave them out, and if they are interested they can find them out for themselves, I don’t want them to accidently read something they didn't want to see. Anyway the results in some studies say the amount of resection played a role in survival regardless of other patient factors e.g. age, health (Mcgirt et al. 2008), (Sinai et al. 2008). I won’t discuss all the outcomes but total amount of resection had positive effects on all outcomes including time taken to become a high grade tumour and progression free survival. There were other studies too, with far more detail, differentiating the subtypes of tumours also. But I’ve lost it because I’m useless. Now I don’t know what category I fall into personally as I haven’t had a post op scan yet. But most surgeons offered me a very Subtotal resection at maximum because of it being on the motor cortex and corpus callosum, but the surgeon I went with offered a much more aggressive option due to his confidence, experience and available technology to avoid harming me.
My advice for anyone facing this decision is go with a surgeon you have the most faith in, as it might have a large impact on your life. With infiltrative Gliomas you can’t possibly get rid of all the rogue cells because they spread throughout the brain. But the more tumour mass removed the less cancer cells you have in your body and therefore the less cells that have the chance to transform into a higher grade. Also if the cells are dividing at a certain rate the less total cells you have left the longer time it will take to grow. I appreciate for a lot of people this is sort of out of their hands as well. But if you are in the NHS you are allowed second surgical opinions for free.
I understand that a lot of people out there will have tumours where gross total resections are impossible or tumours that are completely inoperable, but there are many surgeons who believe surgery has no impact on survival and that the main benefit of surgery is a definitive diagnosis, these are people much more educated and experienced than me so I’m not one to say they are wrong. But on the other side of the fence there are surgeons who argue that resection is important. This blog post is all about doing the best with what you’ve got so if you’re in a position to choose a surgeon, take your time and think carefully, if it’s inoperable there are further things that can be done by yourself.
There are many alternative therapies out there that can work alongside conventional treatment, I am not here to refute or prove their effectiveness. I don’t really have a strong opinion on many of them. What matters is if you believe they work. If you believe they work, even if they actually don’t you’ll still receive a positive affect from them due to the placebo affect and sense of well-being and control. Now I am not saying that alternative therapies only work due to the placebo affect! Whether or not it’s the treatment affect working or not, doing something you believe is working will help your journey. Instead of referencing lots of studies regarding placebos I’ll reference one book which has them all in it, it’s called mind over medicine (Rankin 2013) and it’s a fantastically interesting read.
As this was such a long blog post I think it needs a summary, although the common themes are fairly self-evident. The lifestyle choices I’m choosing to follow involve a whole foods plant based vegan diet, based primarily on a variety of raw and cooked vegetables, beans and fruit for their various benefits which are not even close to being discussed fully in this post. With that I have incorporated a combination of long slow cardiovascular exercise sessions with short resistance training sessions in the gym. Also find surgeons/ oncologists/ neurologists/ other treatments that you have faith in and be happy as often as you can. I’d urge anyone reading to not trust anything I have written because i'm not a doctor and do your own research into what you think is achievable for you. As a side effect of this way of life I have lost most of the weight I gained whilst on steroids. I’ve lost 2stone in 6 weeks which is a bit excessive. Obviously slim people would have to tailor their lifestyle to accommodate not losing too much weight.
If you decide to become a vegan like me, please do your research and supplement with vit b12 because we are lacking in it.
References (a messy
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