Category Archives: Diet, Habits, & Other Behaviors

Good news for coffee drinkers: the health benefits outweigh the risks for most people

Colon Cancer, Diet, Habits, & Other Behaviors, Other Cancers, Skin Cancer, Skin Cancer
By Morgan Wharton, Jessica Cote, and Shahmir Ali ABD

latte-249102_640Most Americans drink coffee every day.1 The caffeine in coffee helps us stay alert but also may cause jitteriness and interfere with sleeping. A few studies suggest that decaffeinated coffee also has health benefits, perhaps because of antioxidants or acids in the coffee bean.2

What Are The Health Benefits Of Drinking Coffee?

For years medical experts advised people to drink less coffee, mostly because of research suggesting coffee might increase the risk of heart disease. However, numerous studies conducted recently have discovered coffee’s unexpected health benefits. Like all well-designed research, most of these studies considered the impact of age, sex, body mass index (BMI), physical activity, tobacco use, and whether family members had developed cancer. By controlling for those factors, researchers made sure they could separate coffee’s impact on health from the effects of people’s lifestyle, family history, and previous health problems. However, the type of coffee you drink may influence its health benefits; a very large study from the UK published in 2022 found that adults who drank larger quantities of unsweetened or sugar-sweetened coffee were less likely to die from cancer in the subsequent 7 years, and also less likely to die from any cause during that time frame.3  However, drinking more artificially sweetened coffee had no impact on cancer or other deaths.

Colorectal Cancer

Meta-analyses are a kind of statistics that combine data from several comparable studies to make one very large study. These results are usually more accurate than any one study can be. Taken together, three meta-analyses suggest that drinking about four or more cups of coffee per day may reduce the chances of getting colorectal cancer by 11-24%.456

Endometrial (uterine) Cancer

Using data from 67,470 women who participated in the Nurses’ Health Study, researchers found that women who drank four or more cups of coffee per day were 25% less likely to develop endometrial cancer than women who drank only one cup of coffee per day. Compared to women who did not drink any coffee, those who drank four cups or more per day were 30% less likely to develop endometrial cancer. Decaffeinated coffee was just as effective as caffeinated coffee, but caffeinated tea did not lower the risk of endometrial cancer.7

Liver Cancer And Cirrhosis (Scarring of the Liver/Chronic Liver Disease)

One study found people who drank one or two cups of coffee per day had a slightly lower risk of getting the most common type of liver cancer compared to non-drinkers, but people who drank three or four cups of coffee were about half as likely as non-drinkers to get this kind of liver cancer. Meanwhile, people who drank five or more cups per day had an even lower risk than that (about one-third the risk of non-drinkers).8

Similarly, a study in Japan found a 76% decrease in the risk of that type of liver cancer in people who drank at least five cups of coffee per day compared to those who did not drink coffee. The strongest benefit was seen in individuals with hepatitis C, a disease which increases a person’s risk of developing liver cancer, although the researchers were not sure why.9

A study of 120,000 Americans over an 8-year period found a 22% decrease in the chances of developing cirrhosis for each daily cup of coffee. In Norway, a 17-year study of 51,000 citizens found that those who drank two or more cups of coffee per day were 40% less likely to develop cirrhosis compared to those who did not consume coffee.10

Skin Cancer

Using data from two enormous studies, the Nurses’ Health Study and the Health Professionals Follow-up Study, researchers found that men and women who drank more than three cups of caffeinated coffee per month were 17% less likely to develop basal cell carcinoma compared to people who drank less than one cup per month. Basal cell carcinoma is the most common and least dangerous type of skin cancer. Drinking decaffeinated coffee did not affect basal cell carcinoma.11

A 2014 study in the Journal of the National Cancer Institute found that the more coffee participants drank, the less likely they were to develop malignant melanoma over a 10 year period. Melanoma is the most dangerous form of skin cancer. Almost 450,000 whites, aged 50-71, participated in the study. Researchers found that drinking four or more cups of coffee per day was linked to a 20% lower risk of getting malignant melanoma. Once again, drinkers of decaffeinated coffee lost out. Their risk of getting melanoma was no different from that of non-coffee drinkers. Coffee drinking, however, did not affect the least dangerous form of melanoma, called melanoma in situ.

Remember that no matter how much coffee with caffeine you drink, the best way to prevent skin cancer is still to limit your time exposed to the sun and ultraviolet light! 12

Type 2 Diabetes

People in Finland consume more coffee than almost any other nation, and a study of 14,000 people over 12 years  found that men who drank 10 or more cups of coffee daily had a 55% lower risk of developing type 2 diabetes than men who drank 2 cups of coffee a day or fewer.  Even more dramatic, women who drank 10 or more cups per day had a 79% lower risk of developing type 2 diabetes than those who drank fewer than 2 cups daily.13

A different Finnish study of 5,000 sets of identical twins found that individuals who drank more than seven cups of coffee per day had a 35% lower risk of type 2 diabetes than their twins who drank two cups or fewer per day.14 Because identical twins are so biologically similar, the difference in disease risk is very likely caused by coffee consumption levels. Studies of fewer people in other countries have found less dramatic but similarly positive results.

Parkinson’s Disease

A study of more than 8,000 Japanese-American men found that men who did not drink coffee at all were three to five times more likely to develop Parkinson’s disease within 30 years than men who drank four and a half cups or more of coffee per day.15

Suicide

Because suicide may be related to alcohol intake, medications, and stress levels, suicide studies took those factors into account.  A 10-year study of 128,000 people in California found that the risk of suicide decreased by 13% for every additional cup of coffee consumed per day. Even one cup of coffee per day seemed to reduce the risk of suicide. A different 10-year study of 86,000 women found a 50% lower risk of suicide for those who drank two or more cups of coffee per day compared to women who did not drink coffee.16

Brain Power and Aging

A study of 676 healthy men born between 1900 and 1920 suggested that coffee helped with information processing and slowed the cognitive decline typical of aging. Cognitive functioning was measured by the Mini-Mental State Examination, a 30 point scale. Men who regularly consumed coffee experienced an average decline of 1.2 points over 10 years, while men who did not drink coffee saw a decline of 2.6 points over 10 years. Men who drank three cups of coffee per day declined only 0.6 points over 10 years.17

Even old mice are sharper with caffeine: a study using a mouse model of Alzheimer’s disease showed that coffee actually reversed the cognitive decline and slow-down in processing that occurred with age. Mice given caffeine in their water showed signs of recovering their memory during testing.18

What about the risks?

Childbearing

Two separate studies found that 300 mg of caffeine (two to three cups of coffee) decreased a woman’s chances of getting pregnant by more than a third. This same amount of coffee also increased the chances of women having low birth-weight babies by 50%. These studies took into account potentially influential  factors such as contraception used in the past and infertility history.19

Hip Fracture

According to data from the Nurses’ Health Study, women aged 65 and over who drank more than four cups of coffee per day had almost 3 times as many hip fractures over the next six years as women who did not drink coffee. Researchers took important factors into consideration such as how much calcium the women consumed each day.20

Parkinson’s Disease among post-menopausal women taking estrogen-only hormone therapy

Other researchers used data from the Nurses’ Health Study to evaluate the risk of Parkinson’s disease among women who drank coffee while using estrogen medication after menopause. For women who were NOT using estrogen therapy, those who drank four or more cups of coffee per day were about half as likely to develop Parkinson’s disease as women who did not drink coffee. For women who did use post-menopausal estrogen, however, those who drank four or more cups of coffee were about twice as likely as those who didn’t drink coffee to develop Parkinson’s.21

Heart Disease

Two different meta-analyses found that people who drank five or more cups of coffee per day were 40-60% more likely to develop heart disease compared to those who did not drink coffee at all. Other studies have also shown that high coffee use (five to ten cups per day) increases the risk of heart disease, while moderate consumption (three to four cups daily) was not associated with a higher risk. Only coffee drinkers who consumed more than nine cups a day had a greater risk of dying from heart disease.22 It is important to consider that people drinking close to 10 cups of coffee a day are likely to have other health problems, such as stress or sleep deprivation, and this could contribute to higher risk of heart disease and death regardless of coffee use.

Bottom line

For most people, drinking coffee seems to improve health more than harm it. Many of coffee’s health benefits increase with the number of cups per day, but even one cup a day lowers the risk of several diseases. However, women who want to get pregnant or already are pregnant and women over 65 should probably limit their coffee intake because, in their case, the risks may outweigh the health benefits.

Even though many studies show coffee has benefits, it’s still not clear why. How can one popular beverage help metabolism (for example, lowering the risk of type 2 diabetes) and also protect against a range of cancers? Until further research can solve that puzzle, most adults should continue to enjoy their cup (or two, or three) of Joe. Finally, remember that nearly all studies on coffee and health have been done on adults. Coffee may affect children and teens differently.

Are Pesticides, Roundup, and Cancer in Children Connected?

Diet, Habits, & Other Behaviors, Environmental Exposures,
By Prianka Waghray and Avni Patel
2022

In murder mysteries, rat poison and pesticides intentionally added to food are sometimes used to kill.  Scientists have also warned they can cause birth defects.  However, more recent research shows that relatively low levels of pesticides and indoor bug sprays can cause cancer and other serious medical problems in children, and possibly adults.

A study published in 2020 found that children exposed to pesticides are more likely to develop cancer later in life. The study highlights an urgent need to prevent and child’s exposure to pesticides 1. Although it was already known that many chemicals used in pesticides, such as certain organophosphates, can cause cancer, the study aimed to find out how much exposure is likely to cause cancer in children.

The evidence about the risks of various chemicals has been growing. There is some evidence that high level of exposures to pesticides, especially among farm workers, may increase the chances of developing lung cancer, but more research is needed on which pesticides are most likely to cause harm 2. In 2019, a University of  Washington study showed that the use of a widely used weed killer called Roundup increases the chances of contracting non-Hodgkin lymphoma by 21% 3.  Children are especially vulnerable to even small amounts of insecticides and pesticides that are meant to kill rodents or insects, even in tick and flea sprays used on pets, because children are smaller than adults and their bodies and brains are still developing.  Roundup, which has been banned in 41 countries as of 2021 due to health concerns, as well as other weed killers are currently being investigated by scientists to learn more about the risks for adults and children. 4.

Even before the latest study, the American Academy of Pediatrics (AAP), which is the nonprofit organization for pediatricians, warned that children can be harmed by pesticides in their daily life.5. The AAP concludes that exposure to pesticides early in life can result in childhood cancers, behavioral problems, and lower scores on tests to measure thinking, reasoning, and remembering. They recommend that parents reduce their children’s exposure to pesticides as much as possible, by controlling bugs and other pests using non-chemical methods whenever possible, and by reducing the amount of pesticides in what children eat and drink.

Several studies have found, for instance, that children exposed to organophosphates, which are common in household insecticides, in their early years tend to have lower IQ and more likely to show the behaviors typical of autism and attention deficit and hyperactivity disorders.6

Several cancer-causing organophosphates have been banned from household pesticides. Unfortunately, they have been replaced with other organophosphates that have not yet been studied. Whether or not these chemicals cause cancer, they can be dangerous and children should not be exposed to them.8

Young children are more likely to be exposed to more pesticides and insecticides than adults because they are closer to the ground and often put whatever they find there, along with their own fingers, in their mouths. When bug spray or other pesticides are used in the home, chemical residues can linger in the air, on the floor or carpet where children crawl and play, and on toys.23 Children breathe in more pesticide than adults, too, because they are down low where the chemicals accumulate. Lawn and garden weed killers can be tracked in the house by pets or people, and left in carpets and rugs.

How can we reduce children’s exposure to pesticides?

The good news is that parents can reduce their children’s exposure to these chemicals. The easiest way is to stop using them in your home and garden. It is also safer to use roach motels, ant baits, and mouse traps instead of chemical sprays. You can weed the yard by hand instead of using weed killers (at least while your children are young).

What about the fruits and vegetables that you buy?  Be sure to wash, scrub, and peel fruits and vegetables if you don’t buy organic produce. Although washing and peeling fruits and vegetables doesn’t get rid of the pesticides that have been absorbed into the growing vegetable or fruit, it is still better than nothing. However, if you can afford to buy them, organic fruits and vegetables have the least amount of pesticide on and inside the fruit or vegetable.24

One way to reduce the use of bug sprays and other chemicals in the home is to not leave out food overnight that can attract bugs or rodents. Discourage rats by covering garbage cans.

If you must use pesticides, use the ones that are less toxic. If you aren’t sure how a product kills pests, look at the label. According to the EPA, pesticides with “warning” on the label are more dangerous to humans than the ones that say “caution.” Products with labels that say “danger” are the most harmful.25 26 Besides using the lowest risk products, be careful where you store pesticides, so that children can’t reach them and the chemicals won’t contaminate foods or medicines.

Is buying organic really better for you?

Researchers at Stanford University have concluded that organic fruits and vegetables are not more nutritious than other produce. However, they also found that children who eat organic produce have significantly lower levels of pesticides in their bodies than children who eat regular produce.27,28,29

Unfortunately, organic fruits and vegetables are not always available, and they are often more expensive. One way to eat organic less expensively is to limit your organic purchases to the fruits and vegetables on the Environmental Working Group’s (EWG) Dirty Dozen list.30 These are the 12 fruits and vegetables that tend to have the highest amount of pesticide residues. The list is constantly being updated based on recent test results so check it regularly (http://www.ewg.org/foodnews/). There is also a Clean 15 list, which lists 15 foods that have the least amount of pesticides and, therefore, are safe even when they are not organic. By following these lists, you can feed your children more safely without breaking the bank.

As of Feburary 2022, the Dirty Dozen consists of the following foods:

  1. Strawberries
  2. Dirty dozen; peachesSpinach
  3. Kale, collard, and mustard greens
  4. Nectarines
  5. Apples
  6. Grapes
  7. Cherries
  8. Peaches
  9. Pears
  10. Bell and hot peppers
  11. Celery
  12. Tomatoes

The Clean 15 list consists of the following foods, where it is not necessary to buy organic:

  1. Avocados
  2. Sweet Corn
  3. Pineapples
  4. Onionsclean 15; red onions
  5. Papaya
  6. Sweet Peas (frozen)
  7. Eggplant
  8. Asparagus
  9. Broccoli
  10. Cabbage
  11. Kiwi
  12. Cauliflower
  13. Mushrooms
  14. Honeydew Melon
  15. Cantaloupe

THE BOTTOM LINE

Even small amounts of pesticides are very harmful for children. They may cause behavior problems, harm children’s thinking and memory, and increase their risk of childhood cancers.  These chemicals can also harm adults, especially after years of exposure.  To help prevent these problems, limit your use of bug sprays, weed killers, and other pesticides and herbicides and buy organic fruits and vegetables that would otherwise have a lot of pesticide residue.

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff. 

 

Lung cancer is a women’s health issue

Diet, Habits, & Other Behaviors, Lung Cancer, Lung Cancer

By Susan Dudley, PhD, Renee Y. Carter, MD, Tiffanie Hammond, and Amrita Ford, MA

Risk Factors for Lung Cancer
Non-Smokers and the Possible Role of Estrogen
Surviving Lung Cancer
Racial and Ethnic Differences in Lung Cancer
Symptoms of Lung Cancer
Lung Cancer Detection and Treatment
Advances in Treatment but They are High-Cost and Only for Some Patients
Funding for Lung Cancer Research

Lung cancer is the #1 cause of cancer death among women in the United States. Lung cancer used to be thought of as a man’s disease, but women now account for almost half of new cases and deaths from lung cancer. In 2014, 48% of the almost 216,000 people diagnosed with lung cancer were women, and 45% of the 155,526 who died from lung cancer were women.31

Lung cancer deaths in women began quickly rising in 1960, and by 1987, the number of female deaths from lung cancer exceeded the number of deaths from breast cancer. Today the number of deaths in women from lung cancer surpasses those from all gynecological cancers combined.32 While the rate of lung cancer deaths among men has been steadily decreasing since the 1990s, the lung cancer death rate among women did not start to go down until a decade later (2003-2007).33 The decline of lung cancer deaths among women, however, may not be as rapid as it has been in men: women born around 1960 with a high rate of smoking are just now entering the age when lung cancer diagnosis is most common.

Risk Factors for Lung Cancer

Everyone knows that smoking is the leading cause of lung cancer. It is responsible for 90% of lung cancer deaths in men and 80% in women. Beginning in the 1940’s during World War II, smoking became more acceptable for American women.34 As more women began to smoke, the number of deaths from lung cancer increased very dramatically among women — by more than 600% between 1950 and 1997. When a woman stops smoking, her risk of developing lung cancer decreases, but not as much as many women may think. Twenty years after stopping, the risk of developing lung cancer drops only by half. In addition, exposure to second-hand smoke at home, work, or other environments—including childhood exposures—can cause lung cancer in women who have never smoked themselves.35

Additionally, exposure to radon, arsenic, asbestos, radiation, air pollution, some organic chemicals, such as benzene, and tuberculosis, also increase the risk of developing lung cancer.

Non-Smokers and the Possible Role of Estrogen

Although smoking increases the risk of lung cancer dramatically, 1 in 5 women diagnosed with lung cancer have never smoked, whereas among men who develop lung cancer, only 1 in 12 have never smoked.436 Of all the types of lung cancer, women are more likely to develop adenocarcinoma, a type of non-small cell lung cancer (NSCLC), which is also the type of lung cancer more commonly found in non-smokers.

It is unclear why non-smoking women are at greater risk for developing lung cancer than non-smoking men. Studies indicate that biological and genetic differences between men and women play a role in susceptibility to lung cancer and the risk of dying from it. Some research shows that estrogen, a hormone found in both men and women but much higher in women, may help certain lung cancer cells to grow and spread throughout the lungs. For example, a 2009 study based on the Women’s Health Initiative showed that post-menopausal women who took estrogen and progesterone combined hormone therapy had an increased risk of dying from lung cancer, regardless of whether they had never smoked, stopped smoking, or were currently smoking (although current and former smokers were at the highest risk for death).37 A 2010 study indicated that post-menopausal women who took hormone therapy for more than 10 years were at an increased risk of developing lungcancer.38  In 2011, a study showed that women who take estrogen-blocking medication like tamoxifen to prevent a recurrence of breast cancer also reduce their risk of dying from lung cancer.39 For both the 2010 and 2011 studies, the link between hormones and lung cancer were maintained regardless of the person’s smoking status. For more information about hormone therapy and lung cancer, read Lung Cancer and Hormone Therapy: Bad News for Former and Current Smokers.

Surviving Lung Cancer

Women are nearly as likely as men to be diagnosed with lung cancer, but on a more positive note, they tend to survive longer than men with the disease. Women generally live longer than men at every stage of lung cancer, regardless of when they were diagnosed, the type of lung cancer they had, or how they were treated.4041 Studies have shown that women with non-small cell lung cancer (NSCLC) have a greater 5-year survival following partial removal of the lung (resection) than men.424344 Women with NSCLC who are treated with chemotherapy prior to removal of the tumor also have better survival rates than men.45 Furthermore, women with advanced lung cancer of any type who undergo chemotherapy survive longer than their male counterparts.46

Why do women with lung cancer live longer than men? No one is really certain. One reason may be that women tend to notice symptoms and go to the doctor earlier than men, allowing the disease to be caught at an earlier stage when the cancer is local (still in the lung) and can be completely removed.47 However, even when researchers control for this and other differences between men and women, women still live longer following surgery.13 For both women and men with lung cancer, complete removal of an entire lobe of the lung (lobectomy) results in higher survival rates than only partial removal of the lung. Younger patients and patients with smaller tumors are more likely to survive lung cancer than those who are older or have larger tumors, regardless of sex.14

Racial and Ethnic Differences in Lung Cancer

The incidence of lung cancer among African American women is about the same as white women yet smoking rates among African American women are lower.48 In 2007, about 16% of African American women smoked, while the rate for white women was about 20%.49 Similarly, African-American men smoke less than white men yet have higher rates of lung cancer. Is there a genetic difference that places African Americans at higher risk? Or are African-Americans exposed to other lung cancer causing bacteria and chemicals that increase their risk?

No one knows the answer yet but there are several explanations for why African Americans—men and women—are more likely to die from lung cancer than white men and women. Even African American women who have never smoked have higher death rates from lung cancer than white women who have never smoked.50 Most experts believe African Americans with lung cancer don’t live as long because they don’t have the same access to health care. For instance, they are less likely to have insurance coverage which could impact diagnosis and treatment options.51 They are less likely to receive timely care and may not receive the most effective treatment for their type of lung cancer.52 One study found that African American patients underwent partial surgical removal of the lung less frequently than white patients. 53 Other factors that may contribute to the lower survival rates of African American lung cancer patients include differences in lung function,20 provider biases,54 inadequate physician-patient communication,55 distrust of physicians and the health care system,56 and a greater likelihood of refusing surgery.57 For more on African Americans and lung cancer, read here.

After African American and white women, native Hawaiian women have the highest incidence of lung cancer, while Hispanic and Japanese women have the lowest rates.20 Unlike other racial and ethnic groups where the incidence of lung cancer in women has increased over time, rates have actually declined among Hispanic women (who are more likely to be non-smokers than African Americans, whites or native Hawaiians): they decreased by 1.5% every year from 1994 to 2003.58 Despite the decline of lung cancer in both men and women, lung cancer remains the leading cause of cancer death among Hispanic men and the second leading cause of cancer death among Hispanic women.

Symptoms of Lung Cancer

The most commonly recognized symptoms of lung cancer include:

  • persistent cough, coughing that wakes you up at night, and/or coughing up blood
  • wheezing and/or shortness of breath
  • chest pain
  • hoarseness
  • swelling of the face and neck
  • loss of appetite and/or unexplained weight loss
  • unusual tiredness
  • recurring pneumonia or bronchitis

Lung Cancer Detection and Treatment

While survival rates for many cancers have improved substantially over the last 30 years, little progress has been made in the survival rate for lung cancer. For example, between 1974 and 2007, the 5-year survival rate for breast cancer increased from 75% to 89% and the 5-year survival rate for prostate cancer increased from 67% to 99%. In contrast, the 5-year survival rate for lung cancer increased from 13% to just under 16% during the same time period.

What would be needed in order for the survival rates for lung cancer patients to parallel that of breast, prostate or cervical cancers? The main problem is that by the time most women are diagnosed with lung cancer, it has already spread to other organs, making a cure extremely unlikely. Pap smears and colonoscopies, for instance, make it possible to diagnose and remove pre-cancerous cells on the cervix or polyps in the colon before they can develop into cervical cancer or colon cancer or spread elsewhere in the body. And while better survival rates for women with breast cancer are mostly attributed to improvements in treatment, mammogram screenings have helped some women by detecting their breast cancer at earlier stages than before, when surgery, radiation, or chemotherapy have an even better chance of eliminating the disease. Earlier diagnosis and more effective treatments, therefore, will be necessary to improve the survival rate of lung cancer.

The National Lung Screening Trial, which started in 2002, evaluated the use of chest x-rays and low-dose computed tomography (low-dose CT scans) for early detection of lung cancer in men and women who were heavy smokers. Each randomized group was screened annually for 3 years. Researchers found that using low-dose CT scans reduced lung cancer deaths by 20% in the high-risk population. Compared to standard x-rays, CT scans may be more effective in detecting nodules and tumors. Based on a 2011 report of the trial, low-dose CT screening could potentially increase the 5-year lung cancer survival rate to 70% if it allowed lung cancer to be detected in its earliest stage (stage 1A), when the tumor is still relatively small, still in the lung, and can be removed easily through surgery.59606162

Although no U.S. public health agency has recommended screening for lung cancer, in January 2013 the American Cancer Society (ACS) did so for the first time, saying that annual screening with low dose CT scans “could save many lives.”63 ACS has recommended that people at highest risk for lung cancer, as defined by the National Lung Cancer Trial, have a discussion with their doctor about the benefits and risks of annual screening. They advised doctors to have this conversation only with patients who match the profile of the people who were enrolled in the National Lung Cancer Screening Trial: current and former smokers who are 55 to 74 years old and have a 30-pack-year history of smoking (20 cigarettes a day for 30 years, 40 cigarettes a day for 15 years, and so on. To calculate your pack years, visit http://smokingpackyears.com/). If the patients are former smokers, they should have quit within the last 15 years.  Doctors should discuss screening with patients only if low dose CT scans and high quality treatment are available in their area, and only if the patient seems healthy and able to undergo treatment in the event that cancer is found.  For all other patients, “there is too much uncertainty regarding the balance of benefits and harms …”

Three other organizations have issued their own slightly different guidelines.  The National Comprehensive Cancer Network has two definitions of high risk: the one used by the American Cancer Society and one that includes people as young as 50 and as old as 79 with only a 20-pack-year history—provided they have one other risk factor for lung cancer such as a family history, Chronic Obstructive Pulmonary Disease (COPD), or exposure to radon.  Given the close link between COPD and lung cancer, the Network’s screening criteria could potentially find more cases of lung cancer than the 30-pack criteria. (For more info on COPD, see Chronic Obstructive Pulmonary Disease and Lung Cancer.) The American College of Chest Physicians and the American Society of Clinical Oncology also have guidelines.  Only time will tell which guidelines work best, but any of these guidelines make it more likely that insurance companies will pay for screening. As a result of the National Lung Cancer Screening Trial, the U.S. Department of Veterans Affairs is starting to implement a screening program using CT scans for veterans at high risk.  However, most government health programs, such as Medicare and Medicaid, do not usually reimburse for lung cancer screening and might not do so until a public health agency has issued guidelines.

Unfortunately, CT scans are not a great solution for finding and diagnosing lung cancer in people who don’t have symptoms and aren’t at high risk. Low-dose CT scans have been shown to produce a high percentage of false positive results (people who the scan says have an abnormality when they don’t have cancer), which can lead to unnecessary lung biopsies. Since lung biopsies can be harmful, low-dose CT as a screening method isn’t useful for the general population. This is unfortunate because women who didn’t smoke are at higher risk than men who didn’t smoke, as are men and women exposed to years of second-hand smoke, but no screening has been found to be appropriate for them. For more information about screening, read Lung Cancer: Who Is at Risk and Can They be Screened?

Advances in Treatment but They are High-Cost and Only for Some Patients

Historically, lung cancer treatments have not been very effective. For instance, erlotinib (trade name Tarceva), which is taken as a pill, extends survival in patients with non-small cell lung cancer by only about 2 months on average and costs anywhere from $2,000 to $5,000 a month.646566 Patients usually take Tarceva after having already undergone chemotherapy, and many use it as a maintenance therapy to prevent further cancer progression and to shrink tumors that are already present. Patients stay on Tarceva for as long as it appears to be having an effect (developing a rash is considered a good sign) and scans show that the cancer is stable. Not only is Tarceva expensive but it doesn’t benefit everyone with lung cancer: it works best in patients who have never smoked or who have a specific gene mutation (EGFR mutation).36[67 Tarceva acts by inactivating the signal in the mutated EGFR gene that makes lung cancer grow.

New targeted treatments that interfere with specific molecules involved in tumor growth and progression and which promote cancer cell death are showing promise in the fight against lung cancer. In August of 2011, the Food and Drug Administration fast-tracked approval for crizotinib (trade name Xalkori) for use in a small subset of lung cancer patients with late-stage, non-small cell lung cancer (NSCLC) who express a rearrangement of the anaplastic lymphoma kinase (ALK) gene. Rearrangement of this gene leads to cancer growth and occurs in 1-7% of NSCLC patients. Xalkori was approved with an accompanying diagnostic test to determine if a patient has the abnormal ALKgene rearrangement.68 Based on an October 2011 study published in Lancet Oncology, the overall survival rate for Xalkori after 1 and 2 years was 74% and 54%, respectively. The recommended dose for Xalkori is 250mg twice daily and the drug costs about $9,600 per month or about $115,000 a year.69 Targeted treatments tend to be very expensive because they are usually taken by a very small number of patients who have limited treatment choices.

Funding for Lung Cancer Research

Far too many women and men are dying of lung cancer every year. Could an increase in research funding result in better screening, earlier diagnosis, more effective treatments, longer survival, and overall lower mortality for patients diagnosed with lung cancer? We believe the answer is “yes.”

The National Cancer Institute is the major source of cancer research funding in the U.S. Comparisons of NCI funding for various types of cancer in 2010 are shown below and clearly show that lung cancer research is under-funded in proportion to how deadly it is for so many people.170 Between 2003 and 2007, NCI funding for lung cancer actually decreased while funding for breast cancer increased.71 The same inequities are seen in funding for prevention. In the Centers for Disease Control and Prevention (CDC) 2008 budget, about $201M was allocated for breast cancer while $104M was allocated for smoking cessation programs (and not lung cancer specifically).72

Total NCI Funding (in millions)

New Cases Diagnosed
(male & female)

Funding per New Case

Overall Deaths

Funding per Patient Death
Lung Cancer

$282.0

221,130

$1,275

156,940

$1,797
Breast Cancer

$631.2

232,620

$2,713

39,970

$15,792
ColonCancer

$270.4

101,340

$2,668

49,380

$5,476
Prostate Cancer

$300.5

240,890

$1,247

33,720

$8,912

 

Many researchers and advocates point to the stigma associated with lung cancer as a reason for why the disease is under-funded.73 Since smoking is associated with the majority of lung cancer cases, many people believe lung cancer patients are responsible for their health problems and therefore not deserving of the same sympathy and research investments that patients of other deadly diseases receive. This attitude may also extend to clinicians who care for lung cancer patients. One study found that physicians were less likely to send their lung cancer patients with advanced stages of the disease to an oncologist than their breast cancer patients.74 Breast cancer patients were also more likely to be referred for further therapy where lung cancer patients were referred for only symptom control. We know now that more complex factors other than cigarette smoking contribute to lung cancer and the lack of funding over the years has hindered researchers from fully understanding why and how this disease progresses in different populations.

So how can we persuade the federal government to fund more lung cancer research? Some think legislation is needed.

In 2008, Congress approved the Peer Reviewed Lung Cancer Research Program which was the first time in history that federal funding was allocated specifically for the study of lung cancer. However, the program is funded by the Department of Defense to study early detection and disease management specifically in military men and women at high risk for lung cancer.

The Lung Cancer Mortality Reduction Act of 2011 is a bipartisan bill currently in Congress which aims to reduce lung cancer mortality by 50% by 2020.75 The bill, first introduced in 2008, calls on the cooperation of the Department of Health and Human Services, Department of Defense, and Veterans Affairs to meet that goal and develop a coordinated plan that addresses the prevention, early detection, and treatment of lung cancer. It would require the National Cancer Institute to review and prioritize research grants related to lung cancer, the Food and Drug Administration to establish quality standards and guidelines for facilities that conduct computed tomography screening for lung cancer, and the Centers for Disease Control and Prevention to establish a Lung Cancer Early Detection Program which would provide low-income, uninsured, and underserved populations at high risk for lung cancer with access to early detection services. For more information and to support this important legislation in the fight against lung cancer, visit http://www.opencongress.org/bill/112-h1394/show.

Smoking cessation products

Diet, Habits, & Other Behaviors, Lung Cancer

It’s hard to quit smoking, but there are products that can help you quit.  No matter how long you have smoked, stopping can decrease your risk of lung cancer and possibly lower your risk of breast cancer.  Here are some important points to remember:

Types of smoking cessation products:

There are two types of smoking cessation products:

  1. Those that contain nicotine to help you reduce your addiction by lowering the levels
  2. Those that do not contain nicotine that are intended to ease withdrawal symptoms

If you use a nicotine replacement product, only use one kind. Do not use gum and a patch on the same day, for example.  Call your health care professional if you experience nausea, dizziness, weakness, vomiting, fast or irregular heartbeat, mouth problems with the lozenge or gum, or redness or swelling of the skin around the patch that does not go away.

Risks

Talk to your health care professional before using these products if you have

  • diabetes, heart disease, asthma, or stomach ulcers
  • had a recent heart attack
  • high blood pressure that is not controlled with medicine
  • a history of irregular heartbeat
  • been prescribed medication to help you quit smoking

Women who are pregnant or breast-feeding should use these products only with approval from their health care professional.

If you take prescription medication for depression or asthma, let your health care professional know if you are quitting smoking; your prescription dose may need to be adjusted.

Products not containing nicotine

Two medicines that do not contain nicotine have FDA’s approval as smoking cessation products. They are Chantix (varenicline tartrate) and Zyban (buproprion). Both are available in tablet form on a prescription-only basis.  Neither of these drugs is recommended for people under 18 years of age.

Both products have serious risks, and can cause changes in behavior, depressed mood, hostility, and suicidal thoughts or actions.  Since quitting smoking is already difficult, does it make sense to take a drug that can make you feel depressed and suicidal. One study found that Chantix is especially likely to cause an increase in reported depression, suicide, and self-injury.  Chantix has other risks as well, and we agree with the researchers who called it “unsuitable” for smoking cessation, unless nothing else has worked.76

Before taking either of these products, read the product’s patient medication guide in its entirety if you use or plan to use either Chantix or Zyban. These guides offer important warnings that you need to know before making a decision.

This article is based on an article on the FDA web site.  For more information, click here.

Quitting smoking: women and men may do it differently

Diet, Habits, & Other Behaviors, Lung Cancer
By Anna E. Mazzucco, Ph.D

Quitting  smoking is hard to do, and new studies suggest that what works for men may not always work for women, and vice versa.  Scientists believe that nicotine is more important for men, while other aspects of smoking seem to be more important for women.  If you are trying to quit, there’s new research that may help you choose the strategy that is most likely to work for you.

Many counselors, quit lines, and other experts recommend talking with your doctor about your interest in quitting or cutting back on the number of cigarettes you smoke. Your doctor will discuss different tools and medications, some of which require a prescription.  Nicotine patches and gum, for instance, can be purchased without a prescription.  These are often used to “step down” nicotine levels (see this article for more information),  but studies have suggested that these medications may work better for men than women, especially when it comes to quitting for good. 77  Other types of medication to help you quit smoking, such as prescription drugs Chantix and Zyban, do not replace nicotine, but instead try to reduce the craving for it.  But these drugs are riskier and have more side effects than nicotine replacements (see this article for more information).

So, what are the other options, especially for women who may not be helped as much by nicotine patches or gum, and who don’t want to use prescription medicines with serious side effects?  Most experts suggest the following:

  1. Plan for success.  Start by picking a good time to quit.  Experts recommend choosing a time of year that is not particularly stressful, since quitting can take a lot of energy.  You might try setting a goal like a “smoke-free” date that is personally meaningful to you—maybe your or a loved one’s birthday, or a holiday.  Some people decide to save the money they would have spent on cigarettes for something special.  If watching your savings accumulate is helpful, consider putting a glass jar somewhere where you can easily see it and get re-inspired daily!  Interestingly, one study showed that women who try to quit during the first half of their monthly cycle (right after menstruation) are more likely to succeed.78
  2. Know yourself.  Quitting can be more successful if you try to identify the situations where you tend to smoke.  Do you have a particular time of day, or group of people that you enjoy smoking with? Anticipate these situations and come up with plans for how to handle them ahead of time.
  3. Find healthier replacements.   Some people find mint gum, lozenges, sunflower seeds or shelled nuts can help reduce their craving for a cigarette.   This may be especially important for women, who often need to replace the hand-to-mouth aspects of smoking as much or more than the nicotine itself.  Research suggests that certain foods might make cigarettes less appealing, such as healthy fruits and vegetables and spicy foods, which might curb the craving for a strong taste.79  Even brushing your teeth can help keep cravings at bay!
  4. Be good to your body.  Regular exercise, such as brisk walking, jogging, yoga or tai chi, can help reduce stress and increase a sense of well-being.  Research suggests that these feel-good replacements may be especially useful for those who smoke to cope with stress. 80  Lungs can quickly begin to heal once you quit smoking.  So breathe deeply and enjoy!
  5. Call in reinforcements.  Next time you feel a craving, try calling a friend, or consider joining a support group.  There are also online quitting tools such as TheExPlan, SmokeFree Women Quit Plan, QuitNet, and Freedom From Smoking Online.  And, you guessed it, there are now many “quitting apps” such as Smoke Out, tweetsmoking, Butt Out, Livestrong MyQuit Coach, and Smoke Break.   Apps can help you count the days since your last cigarette, calculate money saved, show your decreasing risks for diseases, and share your progress with others– and many of them are free. (For a detailed review, see this site). There are also many websites with useful information and links, compiled here by the Center for Disease Control.

Bacteria: the good, the bad, and the ugly

Diet, Habits, & Other Behaviors
Jennifer Yttri, PhD

Bacteria are everywhere, including your entire body. The bacteria in our body weighs as much as our brain–3 lbs! Bacteria can be harmful, but some species of bacteria are needed to keep us healthy. The bacteria on our skin, in our airways, and in our digestive system are the first line of defense against foreign “invaders” (pathogens) that can cause infection and other problems.

Bacteria also act as “tuning forks” for our body’s immune system, making sure it’s pitched just right. The immune system shouldn’t be too sensitive or too sluggish: it needs to respond quickly to an infection but it shouldn’t over-react. (If it does over-react and attacks the body itself, the result is an autoimmune disease, such as rheumatoid arthritis, lupus, or MS). Each person has a personalized collection of bacteria, called the microbiome.81 We acquire our first bacteria while being born, and every day our environment exposes us to more. Some of these bacteria will take up residence inside the body and help develop a robust immune system.

The Good

The species of bacteria that colonize our respiratory and digestive systems help set up checks and balances in the immune system. White blood cells police the body, looking for infections, but they also limit the amount of bacteria that grow there. Likewise, bacteria keep white blood cells from using too much force. Bacteria also help out by doing things cells are ill-equipped to do. For instance, bacteria break down carbohydrates (sugars) and toxins, and they help us absorb the fatty acids which cells need to grow. 82 Bacteria help protect the cells in your intestines from invading pathogens and also promote repair of damaged tissue. Most importantly, by having good bacteria in your body, bad bacteria don’t get a chance to grow and cause disease.

The Bad

Of course, some species of bacteria in your body can result in diseases, such as cancer, diabetes, cardiovascular disease, and obesity. 83  Usually, these diseases happen only when the normal microbiome is disrupted, but that can occur even from antibiotics. Antibiotics kill bacteria, and some of those will be good bacteria that we need to protect our health. When that happens, the bad bacteria that normally are kept in check have room to grow, creating an environment ripe for disease.

Bad bacteria can exist at low levels in your body without causing harm or can grow too much and wreak havoc. Staphylococcus aureus can cause something as simple as a pimple or as serious as pneumonia or toxic shock syndrome. P. gingivalis can cause gum disease, and was recently linked to pancreatic cancer (read our article find out more). Similarly, when not suppressed by good bacteria, Klebsiella pneumonia can cause colitis, and subsequently lead to colorectal cancer. 84

The Ugly

In addition to allowing disease-causing bacteria to flourish, the elimination of good bacteria throws  the immune system out of whack. The result can be simple allergies or very debilitating autoimmune diseases. Without the right balance of bacteria, your body might suffer from constant inflammation.

Inflammation is the body’s alarm system, which calls white blood cells to heal a wound or to get rid of infection. Chronic inflammation, however, can make the body more susceptible to autoimmune diseases and cancer, such as causing inflammatory bowel disease which if uncontrolled can cause colon cancer. 85

The Future

Research suggests that efforts to make a cleaner environment, free from bacteria, are contributing to the rise in obesity, cancer, and heart disease. 86 Experts are trying to figure out how “probiotics” (foods like yogurt with active cultures and dietary supplements that contain live bacteria) can improve our health. Research is underway so  that in the future, specific bacteria may be prescribed as individually tailored treatments for patients.

Our immune system needs the right combination of bacteria so we can stay healthy and rely less on medications. Antibiotics remain a powerful tool to keep us healthy but shouldn’t be used when they aren’t needed. The more we learn, the more we appreciate the power of the bugs inside of us—to heal and not just to do harm.

Related Content:
Pancreatic cancer: could bacteria in our mouth help us detect this deadly cancer sooner?
Fat moms and fat babies? Weight gain during pregnancy
Ten easy tips to get your family eating healthy

Have colon cancer? Skip the hot dogs, deli, and burgers

Colon Cancer, Colon Cancer, Diet, Habits, & Other Behaviors, Uncategorized
Caitlin Kennedy, Ph.D.

New research shows that eating red meat and processed meat increases the risk of colon cancer or of dying from colon cancer. The 2013 Cancer Prevention study by the American Cancer Society has been studying the impact of diet on cancer by following 184,000 patients for 18 years.87

Among the men and women diagnosed with colon cancer, those who ate more than 4 servings per week of red or processed meat before and after they were diagnosed with colon cancer were significantly more likely to die from colon cancer than those who ate fewer than 4 servings per week. Processed meats include deli foods such as hot dogs, sausage, bacon, and bologna, ham and other lunch meats, and bacon. Those who ate more than 4 servings per week had a 79% higher risk of dying from colon cancer compared to those who ate these foods less often. Those who had a family history of colon cancer and ate these foods frequently were especially likely to die from colon cancer.

Remember that “portion” sizes are smaller than what many people typically eat in a meal. For example, 2 hot dogs are considered 2 portions, and one double quarter pound hamburger is considered 3 portions. A large steak could be counted as 3 portions or even more.

Previous research has found connections between eating red meat frequently and an increased likelihood of being diagnosed with colon cancer and other health problems. However, this study is the first to show an increased risk of death from colon cancer.

Bottom line

These very popular foods are more harmful than any of us would like to think. The best way to prevent a variety of health problems, including colon cancer, is to limit red and processed meats in your diet. While the chicken or turkey you make in your oven is fine, the processed chicken and turkey sold at the deli counter or packaged in the supermarket are processed foods. Unfortunately, grilled foods including grilled chicken have also been associated with colon cancer.88 Fish and beans are other healthier sources of protein. If you have a family history of colon cancer, you should be especially careful to eat red and processed meats less frequently. Keep in mind that the American Cancer Society study found an increased chance of dying from colon cancer for men and women who ate these foods either before or after they were diagnosed with colon cancer.

The good news is that it’s never too late to start eating healthy and cutting back on your red and processed meat consumption! Even if someone is already diagnosed with colon cancer, eating less red meat and less processed meat can increase the chances of cancer survival.

Do lemons prevent cancer?

Diet, Habits, & Other Behaviors,
By Caroline Novas
2013

A widely circulating e-mail claiming to be from the Institute of Health Sciences (or the Health Sciences Institute) in Baltimore states that lemons are a “proven remedy against cancers of all types” and that lemons are 10,000 times stronger than chemotherapy.  The e-mail also says that pharmaceutical companies have kept the truth from us because lemons are much less expensive than the less effective synthetic versions that companies can sell for a large profit.

Although there is an “Institute of Health Sciences” in Baltimore that is “dedicated to uncovering and researching most urgent advances in modern underground medicine,” the Institute’s web site has no article about the cancer-fighting properties of lemons. It does, however, contain numerous articles promoting unproven alternative medicines and treatments. Most certainly, is not a credible scientific or medical source.

Regardless of the source, the claims the e-mail makes are NOT correct. Lemons are not a “proven remedy against cancers of all types,” and no studies have ever been done that would compare the effectiveness of a lemon to chemotherapy.

A few studies indicate that lemons and other citrus fruits have naturally occurring substances that may have cancer fighting properties, namely modified citrus pectin and limonoids.  These properties have not been tested in humans.

Modified citrus pectin (MCP)

Modified citrus pectin is a carbohydrate found in the peels of citrus fruits modified to be absorbed into the intestinal tract for easier human consumption. In its natural state, pectin is an indigestible dietary fiber.  Animal studies have found that MCP can inhibit the spread of prostate, breast, and skin cancer to other organs. MCP makes it difficult for cancer cells to break off and spread, although it has no impact on the initial tumor.

However, there is almost no information about whether MCP is effective in humans.  One study that measured prostate cancer in humans treated with MCP after standard treatment failed, showed a slowing in the progression of the disease, as measured by doubling time for prostate specific antigen (PSA). The longer the doubling time for PSA in patients with prostate cancer, the better their prognosis is expected to be. Patients taking MCP for 12 months showed a statistically significant increase in prostate specific antigen doubling time (PSADT), when compared to the 12 month period before they began taking MCP.  Unfortunately, the study used no control group (men that did not take MCP after standard treatment failed) and therefore could not compare the survival rates of men who took MCP after standard treatment failed, with those who did not.

Limonoids

Limonoids are chemicals found in citrus peels that are responsible for lemons’ bitter taste. Research has found that at very high levels, limonoids are capable of slowing cancer cell growth and inducing apoptosis (cell death). However, studies have focused on animals and in vitro human breast cancer cultures (breast cancer cells removed from the human body and studied in a laboratory). As a result, there is little information about limonoids’ effectiveness in preventing or combating cancer in humans.

The bottom line

Although lemons have health benefits, the claims that “lemons are a proven remedy against cancer of all types” and “lemons are 10,000 times stronger than chemotherapy” are certainly false.  Furthermore, while a few studies have looked into the anti-carcinogenic properties of modified citrus pectin and limonoids and found some promising results, not enough research has been done to prove its effects on humans. It’s possible that in the future, after more research, a medicine will be developed to prevent or fight cancer using these ingredients; if so, it will probably be in much higher concentrations than found in nature

MCP and limonoids are not unique to lemons; they are found in all citrus fruits, which have many known health benefits and should be part of any healthy diet.

References:

The Health Sciences Institute. http://hsionline.com/

Glinksy Vladislav and Avraham Raz. (2009). Modified citrus pectin anti-metastatic properties: one bullet, multiple targets. Carbohydrates Research. 28;344(14):1788-91

BW Guess et. al (2003). Modified citrus pectin (MCP) increases the prostate-specific antigen doubling time in men with prostate cancer: phase ll pilot study. Prostate Cancer and Prostatic Diseases. 6, 301-304

Polouse SM, Harries ED, and Patil BS. (2005) Citrus limonoids induce apoptosis in human neuroblastoma cells and have radical scavenging activity.  Journal of Nutrition. 135(4): 870-7

Flaxseed: What is it and Can it Keep you Healthy?

Breast Cancer, Diet, Habits, & Other Behaviors, Other Cancers, Ovarian Cancer
Carla Bozzolo, Cancer Prevention and Treatment Fund

1024px-Brown_Flax_SeedsSuddenly, everyone is talking about adding flaxseed to your diet.  What is flaxseed and how can eating it make you healthier?

What is Flaxseed?

Flaxseed is the seed of the flax plant and can be eaten as whole seeds, ground into a powder (flaxseed meal), or the oil can be taken in liquid or pill form.[1] There is evidence that it is a great way to incorporate dietary fiber, antioxidants, and omega-3 fatty acids into your diet.

Flaxseed has been shown to lower cholesterol in some people and it may even reduce the risk of breast cancer. People take flaxseed to help with many digestive conditions, including chronic constipation, diarrhea, diverticulitis (inflammation of the lining of the large intestine), irritable bowel syndrome (IBS), ulcerative colitis (sores in the lining of the large intestine), gastritis (inflammation of the lining of the stomach), and enteritis (inflammation of the small intestine). According to the National Institutes of Health (NIH), more study is needed to prove that flaxseed benefits people who have these conditions.[2]

What’s in This Miracle Seed?

Omega-3 essential fatty acids

Flaxseed is the richest source of omega-3 fatty acids,3 which is good for our hearts, brains, and normal growth and development.4 Omega-3 fatty acid can also be found in fish, plants, nuts, and oils made from nuts. No matter how you consume flaxseed—whole, ground or the oil—you will increase your intake of omega-3 fatty acids.

Lignans

Lignans are a type of plant estrogen that may help slow down certain cancers—cancers that depend on hormones to grow. Lignans also work as an antioxidant, which means they protect cells from the damage that comes with aging. Antioxidants—found in berries and many other foods—may help fight certain cancers. Lignans are concentrated in the coat of the seed so when flaxseed is expressed into oil, the anti-cancer and antioxidant benefits of the lignans are lost.

Dietary fiber

Dietary fiber helps regulate the digestive system and can lower bad cholesterol. Dietary fiber in flaxseed is only found in whole and ground flaxseeds, not in flax oil.

Flaxseed and Breast Cancer

For women who have gone through menopause, a small daily serving of flaxseed (just over half a teaspoon) was enough to lower breast cancer risk. While more research is needed, some studies suggest that for younger women who have not yet gone through menopause flaxseed reduces the risk of breast cancer and slows down the progress of certain breast cancers and other cancers that need estrogen to grow. A study published in 2013 found that eating flaxseed decreased a woman’s chance of getting breast cancer by 82%.

Flaxseed and Cholesterol

Flaxseed (but not flax oil) seems to decrease bad cholesterol among people who have relatively high cholesterol. Once again, women who already went through menopause seemed to benefit most: their “bad” cholesterol dropped more than the bad cholesterol of men or younger women. This is important for older women, because bad cholesterol tends to increase after menopause, as estrogen levels decline.

Who Benefits the Most?

Flaxseed has the potential to benefit everyone as a great source of dietary fiber with almost no side effects.  People with high levels of bad cholesterol and women who are post-menopausal benefit the most.

Different Ways to Eat It

Flaxseed is sold as whole seeds, ground seeds (flaxseed meal), liquid oil, and oil in a pill form. It can easily be added to cereal, baked goods, salad, yogurt, and many other types of food.  Since whole seeds tend to go through the body undigested, ground seeds are considered to be more beneficial.  Flaxseed oil delivers essential fatty acids but it doesn’t have fiber or lignans. If you want to get all the benefits of flaxseed—omega-3 fatty acids, fiber, anti-oxidant and cancer-fighting properties—choose ground flaxseed.  

Cautions

Few side effects have been reported from flaxseed. When taken to reduce constipation, it should be taken with plenty of water.

The fiber in the flaxseed may also lower the body’s ability to absorb medications that are taken by mouth, so it should not be taken at the same time of day that you take pills or dietary supplements.

The Bottom Line

Flaxseeds are a great source of dietary fiber and omega-3 essential fatty acids for men and women of all ages. They don’t have any known serious side effects, and ground flaxseeds are easy to include in the foods you eat every day.

References:

  1. National Institutes of Health. National Center for Complimentary Medicine. Herbs At A Glance: Flaxseed and Flaxseed Oil. April 2012: http://nccam.nih.gov/health/flaxseed/ataglance.htm
  2. National Institutes of Health. National Library of Medicine. Flaxseed: MedlinePlus Supplements. August 2011. http://www.nlm.nih.gov/medlineplus/druginfo/natural/991.html
  3. National Institutes of Health. National Cancer Institute. Antioxidants and Cancer Prevention: Fact Sheet. July 2004. href=”http://www.cancer.gov/cancertopics/factsheet/prevention/antioxidants”>http://www.cancer.gov/cancertopics/factsheet/prevention/antioxidants  ▲
  4. Brown L, Rosner B, Willett W, and Sacks F. Cholesterol-lowering effects of dietary fiber: a meta-analysis. American Journal of Clinical Nutrition. 1999; 69:30-42.  ▲
  5. Cotterchio M, Boucher BA, Kreiger N, Mills CA, & Thompson LU. Dietary phytoestrogen intake–lignans and isoflavones–and breast cancer risk (Canada). Cancer Causes Control.2008; 19:259–272  ▲
  6. Buck K, Zaineddin AK, Vrieling A, Linseisen J, & Chang-Claude J. Meta-analyses of lignans and enterolignans in relation to breast cancer risk. American Journal of Clinical Nutrition. 2010; 92:141–15  ▲
  7. Velentzis LS, Cantwell MM, Cardwell C, Keshtgar MR, Leathem AJ, & Woodside JV.Lignans and breast cancer risk in pre and post-menopausal women: meta-analyses of observational studies. British Journal of Cancer. 2009; 100:1492–1498  ▲
  8. Lowcock E, Cotterchio M, & Boucher B. Consumption of flaxseed, a rich source of lignans, is associated with reduced breast cancer risk. Cancer Causes Control. 2013. E-publicaton ahead of print. Retrieved from href=”http://www.ncbi.nlm.nih.gov/pubmed/23354422″>http://www.ncbi.nlm.nih.gov/pubmed/23354422.  ▲
  9. Pan A, Yu D, Demark-Wahnefried W, Franco O, and Lin X. Meta-analysis of the effects of flaxseed interventions on blood lipids. American Journal of Clinical Nutrition. 2009; 90:288-297.  ▲
  10. Fukami K, Koike K, Hirota K, Yoshikawa H, and Miyake A. Perimenopausal changes in serum lipids and lipoproteins: a 7-year longitudinal study. Maturitas. 1995; 22:193-197.  ▲

 

Can Taking Fish Oil Supplements Help Lung Cancer Patients Undergoing Chemotherapy?

Diet, Habits, & Other Behaviors, Lung Cancer, Treatment & Management
Katherine Ip, Cancer Prevention and Treatment Fund

Fish oil is a well-known dietary supplement that is likely to reduce the risk of getting heart disease. More research is needed to find out if it may also reduce high blood pressure, menstrual pain, the risk of stroke, and the symptoms of arthritis, bipolar disorder and ADHD.[1]

Some studies have suggested that fish oil and the omega-3 fatty acids it contains might also help improve the effectiveness of chemotherapy for cancer patients, while reducing the bad side effects.  The types of chemotherapy tested include anthracyclines, cisplatin, irinotecan, and alkylating agents. Only two studies were done on humans, and the others were done on animals or cancer cells in test tubes.[2]

Fish Oil Supplements, Lung Cancer, and Chemotherapy

Late-stage non-small cell lung cancer (NSCLC) is usually treated with chemotherapy, but chemotherapy is often ineffective.[3] And, the current treatments have very unpleasant side effects that can severely harm the quality of a patient’s life, so researchers are always looking for ways to minimize damage to the body’s healthy cells while still attacking cancer cells with full force.[4]

In 2011, a very small study by researchers from Canadian Universities looked at whether fish oil could help chemotherapy patients with non-small cell lung cancer (NSCLC) that has spread to the lymph nodes or to other parts of the body (Stage III and Stage IV).[5] Patients with these late stages of lung cancer, on average, only live about 2 years after being diagnosed.

Since the cancer had already spread, all the patients were given the same palliative chemotherapy, aimed at reducing cancer symptoms and improving the patient’s quality of life, rather than curing the patient. Researchers only included lung cancer patients who had never had chemotherapy before. Only 15 of the patients were given fish oil and 31 were not. When they started their chemotherapy, the patients in the group taking fish oil had a choice of taking four capsules a day (each with 1 gram of fish oil), or 7.5 milliliters of actual fish oil, which provides the same amount of omega-3 fatty acids.

How did Fish Oil Affect Survival?

The patients who took fish oil responded much better to chemotherapy than those who didn’t. Their tumors shrank more in size or shrank more quickly, and they were almost twice as likely to be alive a year after treatment compared to the patients who didn’t take fish oil (60% compared to 39%). These results held true regardless of how old the patient was, whether the patient was a man or woman, and how much muscle mass the patient had.  The latter is important because patients with lower muscle mass tend to suffer from more negative side effects from chemotherapy.

Patients who did not take fish oil were more likely to have their cancer get worse after two cycles of chemotherapy than patients who took fish oil. And, more of the patients who took fish oil were able to complete all of their planned chemotherapy, because they experienced less side effects for the same levels of chemotherapy as patients who did not take fish oil. Since the patients who took fish oil felt well enough to receive more cycles of chemotherapy, their tumors also shrank more and they lived longer.

Did Fish Oil Affect Quality of Life?

When chemotherapy kills the body’s healthy cells (think of it like “friendly fire”), it can cause side effects such as nausea, vomiting, and constipation, and it also lowers the body’s ability to fight infection. Since the patients taking fish oil were able to complete more cycles of chemotherapy, we would expect them to have worse side effects. Instead, the side effects listed above were about the same for patients taking fish oil and those that did not. The researchers suspect that the reason why is that fish oil protected the healthy cells from the chemotherapy, but not the cancer cells. Their findings are consistent with a study where mice with lung cancer responded better to treatment when fed fish oil.[6] They are also consistent with a study in which breast cancer patients responded better to chemotherapy when their breast tissue had a higher concentration of DHA, one of two fatty acids found in fish oil.[7]

Is There a Catch?

The study of fish oil and lung cancer included only 31 patients not taking fish oil and 15 patients taking fish oil. Such a small study does not provide adequate evidence, but it does mean more research is warranted.

The Bottom Line:

In this one small study, taking fish oil supplements appears to help late stage lung cancer patients tolerate their chemotherapy better so that they can get the most benefit from it.  And, fish oil is inexpensive and has no known risks. More research is needed to find out if fish oil is usually effective for lung cancer patients and possibly other cancer patients. Since fish oil is very safe, if you or someone you know is about to start chemotherapy, it’s probably a good idea to start taking fish oil supplements right away.

References:

  1. Natural Medicines Comprehensive Database. Omega-3 Supplements: Medline Plus supplements. 2012. Available at: http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html. Accessed February 4, 2013.
  2. Bougnoux P, Hajjaji N, Ferrasson MN, Giraudeau B, Couet C, Le FO. Improving outcome of chemotherapy of metastatic breast cancer by docosahexaenoic acid: a phase II trial. Br J Cancer. 2009; 101: 1978-1985.
  3. Pujol JL, Barlesi F, Daures JP. Should chemotherapy combinations for advanced non-small cell lung cancer be platinum-based? A meta-analysis of phase III randomized trials. Lung Cancer. 2006; 51: 335-345.
  4. Carney DN. Lung cancer–time to move on from chemotherapy. N Engl J Med. 2002; 346: 126-128.
  5. Murphy RA, Mourtzakis M, Chu QSC, Varacos VE, Reiman T, & Mazurak VC. Supplementation with fish oil increases first-line chemotherapy efficacy in patients with advanced nonsmall cell lung cancer.
  6. Yam D, Peled A, Shinitzky M. Suppression of tumor growth and metastasis by dietary fish oil combined with vitamins E and C and cisplatin. Cancer Chemother Pharmacol. 2001; 47: 34-40.
  7. Bougnoux P, Germain E, Chajes V, et al. Cytotoxic drug efficacy correlates with adipose tissue docosahexaenoic acid level in locally advanced breast carcinoma. Br J Cancer. 1999; 79: 1765-1769.