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.
Calorie Reduction
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.
Reduce Inflammation
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
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!
Surgery
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.
Alternative Therapies
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.
Summary
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.
Take Care
Take Care
References (a messy
list sorry)
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doi:
10.1227/01.NEU.0000325729.41085.73
Clinical
Studies
Extent of Surgical Resection Is Independently
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M.D.; Quinoñes-Hinojosa, Alfredo M.D.
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