Blog Highlights:

• While drinks like soda are notoriously loaded with sugar, the direct impact on pancreas cancer remains unknown
• Attention on drinks and cancer began when a flawed study from Harvard was published years ago in the very prestigious New England Journal of Medicine
• For now, keep in mind that while sugar-loaded may not cause cancer, drinking more than a moderate amount of soda is bad for your health

Every few years a study comes out suggesting that a drink like coffee or soda is associated with cancer, and pancreas cancer is the most common type implicated.  The attention on drinks began when a flawed study from Harvard naming coffee as a cause of pancreatic cancer was published years ago in the very prestigious New England Journal of Medicine.  Well that may have been one of the most embarrassing studies that journal ever published.  The design flaw of the study was clear to everyone after the publication.  The sigh of relief lasted a while until a theory surfaced that the sugar in soda could overstimulate the pancreas.   This theory is based on the premise that the massive sugar load in modern day drinks is unnatural and the pancreas was not designed to handle such an over-stimulation.  You see the pancreas is responsible for sugar regulation, producing important hormones like insulin and glucagon to control a body’s uptake and use of sugar.

The truth is that while drinks like soda are notoriously loaded with sugar (several teaspoons worth), the direct impact on pancreas cancer remains unknown.  Some studies have suggested the association, like a recent study from the University of Minnesota published this year, but they have not had the statistical power to prove the association.  Demonstrating the association, if present, would take lots of patients.

Soda’s do not appear to be a direct cause of pancreatic cancer although I believe that future research may show how the sugar load is harmful to the pancreas.  For now, keep in mind that while sugar-loaded may not cause cancer, drinking more than a moderate amount of soda is bad for your health.  Furthermore, it is well-recognized that sugary drinks play a part in our American obesity epidemic–a problem rampant among children in particular.  And obesity is a known risk factor for cancer, heart attacks, and premature death.

Blog Highlights:

• Certain types of cancer like colon cancer have a slight association with a high-fat diet
• Avoid hydrogenated and trans fats, and seek out Omega 3 or Free Range products in your diet
• Big industries introduce products to market faster than the public health community can study them
• Until the research community catches up with the processed food industry, eat local food, organic food, and clean water seafood

Here are eight important diet tips, and read more below for an explanation of these points:

1) Look for free range milk, eggs and meats
2) Take Omega 3 supplementation
3) Seek wild-caught fish
4) Ask for clean water seafood
5) Buy organic foods (chemical-free)
6) Avoid hydrogenated fats
7) Avoid processed food
8) Eat local

50 years ago our food largely came from local farms with green pastures.  Today, most food we eat comes from factories and it travels 1,500 miles before it’s consumed.  At the same time we are seeing an increase in certain types of cancer, despite many medical advances.  Is there a connection?  Its simply too hard to study something that broad to say definitively.  But consider the following points when choosing your food.

Studying the cause of cancer is extremely complex.  Assessing the 20 or 30  year effects of environmental or nutritional changes on cancer is difficult to measure and costly to do right.  Also, the absence of research supporting a connection does not mean there isn’t one.

Historically, public health research has lagged behind the introduction of cancer-causing agents in the environment.  Big industries introduce products to market faster than the public health community can study them.  Take for example, cigarettes.  It took decades for public health researchers to confirm what they had long suspected–that they are bad for your health and cause cancer.  Cancer is believed to be multi-factorial, which means it could be caused by a combination of internal, genetic, and/or environmental factors.  What we do know is that certain types of cancer like colon cancer have a slight association with a high-fat diet.

Food increasingly is processed and not natural.  It has more fat, sugar and artificial ingredients.  Some in the public health community have warned that such processed food could be associated with certain types of cancer.   When animals are fed corn products and denied green pastures as they are when raised in factory farms, they concentrate the wrong types of molecules in their system.  This is so common that many doctors now recommend that patients take Omega-3 pills to balance out the high Omega-6 fats found in most processed food.  The use of Omega-3 has been studied and found to be beneficial in preventing repeat heart attacks, and that’s probably just the beginning of what we are learning about the Omega fat imbalance.  So avoid hydrogenated and trans fats, and seek out Omega 3 or Free Range products in your diet.

One great source of Omega 3’s are fish.  Specifically its high in fish livers which are purest in clean waters like Norway or Alaska.  Unfortunately, seafood increasingly come from areas where toxic metals are found, such as the Atlantic coast and the Gulf of Mexico.  Omega 3 pills extracted from small fish in Virginia, for example, are loaded with pollutants.  Alaskan fish on the other hand come from clean waters and are an excellent source of Omega 3’s.

Free Range food is important for good health because Free Range animals get more appropriate nutrition for their muscles.  Those muscles are what we eat as meat.  Most any fast food has factory-farm style animals raised under inhumane conditions, fed processed corn products.  The movie “Food Inc.” exposes this industry showing how the artificial food is even spray-painted green at times to trick the chickens into eating it.  Those chemicals can’t be good for your body.  Free Range foods are safer and more likely to be chemical free.  Free Range products taste better too.

Every nutritionist agrees that our consumer culture has minimized fruits and vegetables.  These are important for many reasons, including the magical potential of anti-oxidants.  Its believed that these compounds may have a slight benefit in preventing cancer, although further research is needed to know if they are really helping.  At minimum fruits and vegetables are important for balancing one’s diet.  A good variety of fruits and vegetables may eliminate the need to buy expensive vitamins, although Vitamin D and iron supplementation may still be recommended by your doctor if your levels are low.

Finally, the organic movement is good for public health.  There are many theories that genetically modifiable food and food grown with pesticides are not good for your health.  Trace amounts of pesticides have been detectable in people’s blood, and over years, such an accumulation of chemicals could be shown in the future to have an impact on cancer.  I highly recommend organic foods to young patients interested in taking care of their health and reducing their risk of cancer.  Until the research community catches up with the processed food industry, eat local food, organic food, and clean water seafood.

For related information, here’s another blog you might find helpful:

“Important Diet Tips for Cancer Prevention“

Here’s news about a major advance in colorectal cancer screening and detection. Dr Sanford Markowitz is a leading colorectal researcher. He is featured in this video from Case Western Reserve Medical Center in Cleveland where he describes a new, commercially available test for detecting colorectal cancer with an impressive 80% accuracy. The test is called Colosure and covered by a number of insurance plans. It is important to remember that it is not a substitute for colonoscopy, which still remains the “gold standard”. Nevertheless, it represents the future of our ability to detect cancer earlier with genetic and molecular tests. For more information, check out my blog “Why Does Family History Matter?”

Here are examples of cancers that have been linked to family history and genetics from our companion website patientresource.net:

Abnormalities in the BRCA1 and BRCA2 (breast cancer 1 and breast cancer 2) genes were among the first cancer-related gene mutations to be identified. Mutations in either of these genes increase the risk for breast and ovarian cancer (see Table 2 on page 41). Thus, this hereditary cancer is referred to as hereditary breast and ovarian cancer syndrome. The risk of certain other cancers may also be higher in people with this cancer syndrome.

There are several forms of hereditary colorectal cancer. The most common form is hereditary nonpolyposis colorectal cancer (or Lynch syndrome). This hereditary cancer syndrome is also associated with an increased risk of uterine and ovarian cancer as well as upper-gastrointestinal tract cancers and cancer of the urinary tract and kidney. Other types of hereditary colorectal cancer syndromes are associated with multiple polyps that grow in the colon. The most common of these polyposis syndromes include familial adenomatous polyposis (FAP), attenuated FAP (AFAP), and MYH-associated polyposis (MAP). In FAP, hundreds to thousands of polyps develop in the colon over a lifetime, and they can start developing as early as childhood. In AFAP, fewer than 100 polyps usually develop. In MAP, the number of polyps that develops ranges from a few polyps to thousands. Additional polyposis syndromes exist, and your doctor may suggest that you be tested for these syndromes, depending on the number and type of polyps seen on colonoscopy.

A genetic mutation has also been linked to melanoma. Hereditary melanoma is not as well understood as the other hereditary cancer syndromes, and researchers continue to learn more about the genetic mutations that may be responsible for this hereditary cancer. Hereditary melanoma is also associated with an increased risk for pancreatic cancer.

Colon cancer can be a “silent killer” because it can grow for some time without causing any symptoms. Sometimes a colon cancer can be quite advanced before a person knows it is there. That is the bad news. The good news is that colon cancer is preventable or curable if it is discovered early. The best way to do that is to have a full colonoscopy to visualize the entire length of the colon and biopsy or remove any polyps or abnormalities. Colonoscopy is not a particularly comfortable procedure, but it can be a lifesaver. Typically, the first colonoscopy is recommended at age 50. However, it may be necessary to start at an earlier age, especially for those who have increased risk such as having ulcerative coloitis or a family history of colorectal cancer.

For those of you interested in learning more about screening for colon cancer, this video offers a good overview and dispels some common myths.

This video discusses the link between vitamin D deficiency and cancer. It is an informative interview with Cedric Garland from Moores Cancer Center and Department of Family and Preventive Medicine, University of California at San Diego. The particular focus in this video is about cancer prevention and screening.

See my other blog which includes a very thorough video about vitamin D deficiency being more prevalent in women with breast cancer:

“What Does Vitamin D Have To Do with the Breast Cancer Risk?”

Here’s a video about the benefits of aspirin for colon cancer. Below is an interesting article published in the medical journal Lancet Oncology about the value of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) as cancer prevention agents. The evidence about their benefit in preventing cardiovascular disease and various forms of cancer, particularly colorectal cancer, is getting stronger.

Lancet Oncol. 2009 May 1;10(5):501-507, J Cuzick, F Otto, JA Baron, PH Brown, J Burn, P Greenwald, J Jankowski, C La Vecchia, F Meyskens, HJ Senn, M Thun

Evidence clearly shows a chemopreventive effect for aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) on colorectal cancer and probably other cancer types; however, data on the risk/benefit profile for cancer prevention are insufficient and no definitive recommendations can be made. Aspirin has emerged as the most likely NSAID for use in chemoprevention because of its known cardiovascular benefit and available safety and efficacy data. Other traditional NSAIDs, particularly sulindac, and selective COX-2 inhibitors are now given to patients at high risk of colorectal cancer, although these drugs do not provide cardioprotection. More studies of aspirin and cancer prevention are needed to define the lowest effective dose, the age at which to initiate therapy, the optimum treatment duration, and the subpopulations for which the benefits of chemoprevention outweigh the risks of adverse side effects. Although it might be possible to answer some of these questions with longer follow-up of existing clinical trials, randomized controlled trials with new study designs will be needed. Future projects should investigate the effects of aspirin treatment on multiple organ systems. Cancers of interest are colorectal, breast, prostate, lung, stomach, and esophageal.