Cancer prevention
BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7517.618 (Published 15 September 2005) Cite this as: BMJ 2005;331:618
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how to minimise her risk of developing cancer' article to suggest that
most cancer can be 'beaten' or 'cured'. For example, there is no
evidence that the caveat about a high-fat diet is well founded, i.e. if omega-3 fatty acids reduce cell proliferation and omega-6's promote it, the net effect could be neutral and the implication that lower 'fat' diets
are protective is imprecise advice to a patient, as well as not based on intervention studies.
There is no mention that primary cancer prevention with micro-nutrients such as selenium
is of probable benefit, and that correcting low intakes of B-vitamins and
some minerals is both economical and probably effective (2,
3).
The authors of (2) report that a 10 fold reduction of folate alone (in
vitro) is equivalent to 1 or 2 orders of magnitude greater DNA damage
than that caused by the maximum yearly allowed exposure to X-ray radiation.
There is no doubt that common low-micronutrient intakes (easily corrected
with a high dose multivitamin / mineral tablet) causes such DNA damage
that mimics radiation damage and that may well underlie much of cancer
(3).
We are all concerned about radiation and free-radical damage and recommend
challenging 'life-style' changes while ignoring the easiest change
that can be made by all qualifying for primary prevention. That is, a simple micro-nutrient supplementation programme as the safest prevention avenue of them all and of probable benefit to the mid-aged patient taken as example.
While the results of micro-nutrient supplementation in individuals is impossible to predict decades in the future, nobody would propose that living with known high levels of DNA damage mimicking radiation damage can be of benefit, and it sure beats most therapies proposed by oncologists
when cancer has become a reality, including the DNA toxic X-ray route.
vos{at}health-heart.org
1. Clark LC, Dalkin B, Krongrad A, Combs GF Jr, Turnbull BW et al Decreased
incidence of prostate cancer with selenium supplementation: results of
a double-blind cancer prevention trial. Br J Urol. 1998 May;81(5):730-4.
Medline 9634050.
2. Fenech M. Nutritional treatment of genome instability: a paradigm
shift in disease prevention and in the setting of recommended dietary allowances.
Nutr Res Rev (2003) 16:109-22. DOI: 10.1079/NRR200359
http://med.unr.edu/homepage/zehd/Fenech2003.pdf
3. Ames BN. DNA damage from micronutrient deficiencies is likely to
be a major cause of cancer. Mutat Res. 2001 Apr 18;475(1-2):7-20. Medline
11295149.
Competing interests:
None declared
Competing interests: No competing interests
Like many other readers, I was impressed by the conciseness of the 10
-minute consultation on Cancer prevention submitted by J Jankowski and E
Boulton (BMJ 17 Sept 2005). However, I am concerned that among the 4
desirable lifestyle modifications (smoking, exercise, dietary modification
and alcohol consumption), the patient should be invited to decide "what to
tackle first".
In my view, we should not to rule out the idea of tackling several of
these factors - if not all 4 - at the same time. For decades, clinicians
have balked from asking their patients to stop smoking and cut down on
alcohol simulaneously, and it has taken many painstaking studies to
finally realize that it is OK to tackle these two factors together, if the
patient wants to try. Pilot studies combining smoking cessation with
physical activity are now in progress in various countries, sometimes with
elements of nutrition too.
Rather than the lack of willing patients, the main obstacle may be
finding health care workers able - and willing - to give advice on all
these factors (I totally agree with the list of 4 given by Jankowski and
Boulton, valid not only against cancer but also against cardiovascular and
pulmonary diseases). If this is the case, specific training in these 4
areas, and how to combine them, should be given. Why not on a voluntary
basis, for all medical doctors, nurses, psychologists, scientists, etc.
who are interested?
Competing interests:
In 2005, DH Christie participated as a paid consultant in a pilot study combining smoking cessation, physical activity and nutrition counselling.
Competing interests: No competing interests
Thank you for the brief concise and helpful 10-minute consultation
concerning cancer prevention. I want to strongly encourage a similar
article for the topic of the possible and proven effects of physical
activity on cancer risk.
Competing interests:
None declared
Competing interests: No competing interests
Dear Editor,
Vaccination for certain viral infections such as viral B hepatitis
can prevent hepatocellular carcinoma.HIV infected persons are also at risk
of developing different malignancies and hence prevention of HIV infection
is an important step in cancer prevention.Patients receiving cytotoxic
agents are at risk of developing cancers such as leukemias,lymphomas.So
their use should be minimised wherever possible.Radiaton exposure is an
well known risk factor and protection from it can prevent development of
many cancers.
Competing interests:
None declared
Competing interests: No competing interests
Sir/madam,
Thanks for this article covering all points methodically.
While dealing with the prevention of colon Cancer is it necessary to ask about
beef eating- ?prediposing factor for colon cancer.
Dr.Chidambaran
Competing interests:
None declared
Competing interests: No competing interests
Meat intake proportional to cancer risk
I thank Dr Chiambaran for his question regarding dietary intake of
meat and cancer risk. In general terms red meat and indeed even bacon and
chicken meat has been associated with increased cancer risk of several
organs including colon and pancreas (about a 20-30% increase) (1, 2). In
general terms the protein component of meat should be replaced in
alternate meals by protein in pulses, (low fat)dairy products and other
vegetable proteins as a lower intake is proportional with a lower cancer
risk. If meat is to be eaten it should not be cooked at high temperatures
or burnt.
1. Norat T, Bingham S, Ferrari P et al, Meat, fish and colorectal
cancer risk: the European Prospective Investigation into cancer and
nutrition. J Natl Cancer Inst 2005;97:906-16.
2. Sinha R, Peters U, cross AJ, Kulldorff M, Weissfeld JL, Pinsky PF,
Rothman N, Hayes RB. Meat, meat cooking methods and preservation, and risk
for colorectal adenoma. Cancer res 2005;65:8034-41
Competing interests:
vegetarian
Competing interests: No competing interests