Cancer Connection: The Role Diet Plays In Cancer Prevention Is Becoming Clearer, But There Is Still Some Confusion And Debate (The Miami Herald)

July 9, 2009

Source Date: July 7, 2009
Source Author: Julie Kay
The Maimi Herald

Allan Cohen, a 66-year-old Aventura resident, dramatically changed the way he ate after being diagnosed with prostate cancer 15 years ago.

The son of a butcher, Cohen says he reluctantly cut ''way down'' on meat and fats and introduced more fruits and vegetables in his diet.

''I'm more cognizant of the foods I eat,'' Cohen said. "I want to live a long time.''

Cohen is not alone in his new eating habits. As the link between diet and cancer becomes clearer, and studies show some links between certain foods and cancer, people are increasingly looking to nutrition as a way to prevent or even survive cancer.

But the public, and cancer survivors in particular, say they are trying to educate themselves on how foods might relate to cancer after getting little information from their doctors on the matter other than general recommendations for an overall healthy diet. ''A lot of people who come here say they don't hear anything about nutrition from their doctors,'' said Sue Cleveland, a spokeswoman for Gilda's Club of Fort Lauderdale, a support group for cancer patients and their families. "They learn from each other.''

Part of the problem: there is little agreement on what actual foods comprise a cancer-preventative diet, with hundreds of studies for people to sift through, some with conflicting information. For example, soy-based products, which were touted as recently as last year as a potential tool for cancer prevention, have now been linked to certain types of breast cancer.

However, agreement has become fairly universal on some basic diet recommendations -- among them, to eat more than five servings of varied fruits and vegetables a day (the more colorful, the better), choose fiber and multigrains, and eat lean meat such as chicken and fish. People are advised to reduce their consumption of red meat -- beef, lamb and pork -- as well as cured meat such as cold cuts and hot dogs, fat in general and alcohol.

Few studies have conclusively linked certain foods and drinks to cancer, but there are a couple. One food-cancer link involves cured meats such as cold cuts, which have been shown to cause colorectal cancer in several studies published in the Journal of American Medicine in 2005, the International Journal of Cancer in 2006 and others.

And alcohol has been linked to breast, stomach, esophageal and colon cancer in studies published in the Journal of the American Medical Association in 1998, the Annals of Internal Medicine in 2004 and the British Journal of Cancer in 2002. However, some medical researchers have speculated that red wine might actually protect women from breast cancer -- basing their theory on studies on red wine's positive effects on heart disease and prostate cancer risk. A 2006 study published in Cancer Epidemiology, Biomarkers and Prevention of 6,327 women with breast cancer and 7,558 healthy women concluded that neither red wine nor white wine had any effect on cancer risk. But it said women taking more than 14 drinks a week of any kind of alcohol had a slightly higher cancer risk.

Also, obesity in general has been linked to cancer of the breast for women who have gone through menopause, as well as colon, uterus, esophagus and kidney cancers. As a result, the American Cancer Society recommends a healthy, low-fat diet in general -- the same basic prescription from other medical groups, such as the American Heart Association.

'IT'S THE MIX'

''When you look at all the evidence, it's the mix of foods that people eat that offers the most protection, it's the synergy of antioxidants and vitamins -- not just one food,'' said Colleen Doyle, director of nutrition and physical activity at the American Cancer Society. "A story will come out -- eat blueberries and you won't get cancer. There isn't evidence that one food alone will prevent cancer.

''One of the key things to keep in mind is, even more than what foods people eat, it's how much they eat,'' she added. "People really need to watch their weight to reduce the cancer risk.''

Adding to the confusion is the fact that some groups that teach people how to battle cancer through nutrition may have other agendas. One of those is the Cancer Project, a Washington, D.C.-based nonprofit that is part of the Physicians Committee for Responsible Medicine, a group that has a strong animal rights focus and advocates against animal testing. The group, which offers cooking courses aimed at preventing or surviving cancer, cites studies done in Germany that show those who eat a plant-based diet have a 40 percent less chance of contracting cancer.

Though its philosophy and advice to avoid meats and dairy products at all costs sometimes clashes with other groups such as the American Cancer Society, there is general agreement that fruits and vegetables are important parts of the diet.

The Cancer Project is now offering a series of sessions at Aventura Hospital and Medical Center. At a recent class attended by about 30 cancer fighters, survivors and family members, Cancer Project instructor Janelle Hoilett prepared several bean-based dishes, including dip and hummus. She poured samples of soy milk, rice milk, almond milk and hemp milk, cautioning that cows' milk can lead to tumor growth.

The group also advises abstention from eggs, fish, cheese, meat and other dairy products. ''You need to look outside a Western diet,'' Hoilett said. "We preach to eat more fiber and antioxidants.''

However, hospital dietician Iris Baker continually jumped up throughout a recent one-hour class to counter some of Hoilett's claims, particularly when Hoilett called cows' milk dangerous.

''There is a big controversy over whether they are injecting hormones into milk,'' Baker said. "I drink skim milk. Some people need milk to get their B vitamins. Publix now says its milk is hormone-free.''

When Hoilett was preparing the bean salad, Hoilett cautioned those with high blood pressure to use low-sodium beans. She also warned against excessive sugar consumption -- especially when Hoilett described how she makes almond milk by blending bananas and almonds.

The American Cancer Society takes issue with the group for not disclosing its roots as an animal rights group, and says some of the group's claims are not backed by scientific evidence.

''Our take on the evidence is that eating a vegetarian diet or eating that strict of a vegetarian diet offers no more cancer prevention,'' Doyle said. "We disagree with what they are doing to the extent that consumers may not be getting the full picture. If there was evidence that cutting out lean turkey or chicken or fish prevented cancer, we should be talking about it. But the evidence is not there.''

However, the American Cancer Society, as well as Aventura Hospital representatives, say the Cancer Project offers much positive nutrition advice, such as eating more fruits and vegetables, beans, multigrain breads, and lower fat in general.

''I suspected they were part of some militant animal rights group, but I had a dietician there,'' said Phil Fusca, cancer care coordinator for Aventura Hospital. "If someone can get something good from this in terms of survivorship, that's my goal.''

When asked about her group's main focus, Edith Sodolo, a spokeswoman for the Cancer Project, said, "PCRM does have two focuses, one is nutrition and the other is ethical scientific research. Animal testing is not ethical and not necessary.''

As to the question of whether dairy products are truly linked to cancer -- the American Cancer Society says they aren't, and The Cancer Project says they are -- Sodolo said, "That's a controversial question, I've gotten that question before. We really require people to maintain communications with their doctors.''

FOLLOWING THROUGH

Educating people on eating a diet that lowers the risk of cancer or recurrence is one thing. Getting them to follow the plan is another, medical experts agree.

After the cooking class Cohen, the butcher's son, said he does not plan to give up red meat entirely, although he has cut down.

And Rhoda Rosenfield, an 87-year-old Pembroke Pines resident who survived breast cancer and is fighting lung cancer, said she would never give up her beloved hot dogs. ''I love hot dogs, more than lobster, more than anything,'' Rosenfield said.

''Diet is very individualized,'' said Dee Sandquist, a dietician in Portland, Maine, and spokeswoman for the American Dietetic Association. "We look at the total diet approach -- gradually increasing fruits and vegetables, adding in exercise. Everyone is genetically different. We certainly do need more research.''