Her recent breast surgery went perfectly. The tumor is out, margins are clear, and none of her scans show any cancer. So, she is understandably distraught when I begin to discuss the option of chemotherapy. “But I thought they got it all,” she says.
As a medical oncologist, I have had some version of this conversation hundreds of times, but it never gets easier. We call it adjuvant therapy — the medical practice of giving a person four to six months of chemotherapy after their cancer surgery, just in case. The underlying logic of adjuvant therapy rests on a single uncomfortable fact.
The practice of oncology is hard. I hope you never have to make a decision regarding adjuvant chemotherapy.
—–Steve Parker, M.D.
PS: The Mediterranean diet is linked to lower risk of getting cancer.
You can read about this (or watch the video) at various places. One is TheFocalPoints.com.
“84.4% of Cancer Patients Taking Ivermectin + Mebendazole Reported No Evidence of Disease, Tumor Regression, or Cancer Stabilization After 6 Months”
It just sounds too good to be true. And you know want that usually means. I’ve not done a deep dive into this report but I’m very skeptical. The study lumped a bunch of different cancer types together: breast, pancreas, colon, lung, etc. The uneducated among us may think all cancers are alike. They are not. They behave differently and, traditionally, require different therapeutic approaches for the best outcome. If (and that’s a big IF) there is a unifying underlying chemical or cellular phenomenon that causes all cancers, then a panacea like ivermectin/mebendazole may be an effective treatment. (In case you’re wondering, I was prepared to take ivermectin during the pandemic but never did.)
Just a reminder, I am not a cancer specialist. If I had cancer, I would consult a cancer specialist, typically an oncologist.
Authors of the study at hand do note that “…these findings should be interpreted as hypothesis-generating. Urgent prospective, randomized, placebo-controlled clinical trials are warranted to validate these observations and further define optimal dosing strategies.” You may recognize one of the authors, TV celebrity Dr. Drew Pinsky. What a Renaissance man! Other familiar author names are Peter McCullough and Harvey Risch.
This is a shoddy research study presented as a quality improvement project. This dubious classification functioned as an excuse for lack of interface with relevant regulatory bodies.
There is validity to the assertion that ivermectin and mebendazole show anticancer activity in preclinical studies. This study provides no meaningful evidence for or against the efficacy of such treatments in humans with cancer.
—–Steve Parker, M.D.
PS: Did you know there’s a way of eating that’s linked to lower risk of developing certain common cancers? It’s the Mediterranean diet!
Olives, olive oil, and vinegar: classic Mediterranean foods
The traditional Mediterranean diet has long been linked to lower risk of certain cancers, particularly colon, breast, uterus, and prostate cancer. That’s one reason the diets usually ranked as the #1 healthiest diet in the U.S. News and World Report’s annual diet survey. A new study of a Netherlands population suggest that the anti-cancer benefit applies only to women. From a 2020 issue of the Journal of the Academy of Nutrition and Dietetics:
In this NLCS analysis, sex-specific associations of a priori defined Mediterranean diet adherence with risks of overall cancer and cancer subgroups defined by relations with 3 major cancer risk factors (tobacco smoking, obesity, and alcohol consumption) were investigated. In women, middle compared with low aMEDr values [alternate Mediterranean diet score without alcohol] were significantly associated with a reduced risk of overall cancer and the majority of the cancer subgroups investigated. Other associations in women were not statistically significant after full adjustment for confounding, but all estimates were below 1. No association was observed between aMEDr and risk of overall cancer or any of the cancer subgroups in men. Inclusion of alcohol in the Mediterranean diet score diminished the model performance.
Even though the association of Mediterranean diet adherence with overall cancer risk is comprised of a combination of potentially diverging associations with individual cancer (sub)types, overall cancer risk is an interesting end point for epidemiological studies. It provides insight in the overall possible benefits of Mediterranean diet adherence and the potential of the Mediterranean diet as a dietary strategy for cancer prevention. Findings of previously conducted prospective studies evaluating the relation between a priori defined Mediterranean diet adherence and overall cancer risk have been inconclusive and were rarely specified by sex.
A priori defined Mediterranean diet adherence has previously significantly been associated with a reduced overall cancer risk in the total European Prospective Investigation into Cancer and Nutrition (EPIC) cohort as well as the Greek EPIC cohort.9,10 Comparing the highest with the lowest Mediterranean diet adherence category in the total EPIC cohort, HRs (95% CIs) of 0.93 (0.88-0.99) and 0.93 (0.89-0.96) were observed for men and women, respectively. Although inverse associations were also suggested for both sexes in the Greek EPIC cohort, only effect estimates obtained in women reached statistical significance (HRhigh vs low [95% CI]: 0.83 [0.63-1.09] for men and 0.73 [0.56-0.96] for women). In addition to the previously mentioned EPIC studies, weak inverse associations between Mediterranean diet adherence and overall cancer risk were observed in men (HRper tertile increase [95% CI]: 0.97 [0.94-1.01]) and women (HRper tertile increase [95% CI]: 0.97 [0.93-1.00]) participating in the Swedish prospective Västerbotten Intervention Programme. In the present analysis of the NLCS cohort, a priori defined Mediterranean diet adherence was not associated with overall cancer risk in men. In regard to women, although the multivariable-adjusted associations in female NLCS participants were not statistically significant in most cases, effect estimates were stronger inverse than those observed for women in the total EPIC cohort, which did reach statistical significance possibly due to the larger number of cases. Additional cohort studies in Germany and France have investigated the association between Mediterranean diet adherence and overall cancer risk in men and women together and did not observe an association. Besides the prospective cohort evidence, a reduced overall cancer risk (borderline significant, P = .05) was indicated in patients with coronary heart disease who followed an α-linolenic acid-rich Mediterranean-type diet as opposed to a control diet close to the step 1 prudent diet of the American Heart Association in the randomized Lyon Diet Heart Study. However, results should be interpreted with caution because they were based on only 24 incident cancer cases.
Exercise is a fountain of youth available to every one
From UPI:
In findings published Thursday in the Journal of Clinical Oncology, researchers at the National Cancer Institute, the American Cancer Society, and the Harvard T.H. Chan School of Public Health report that people who engaged in physical activity as recommended by the National Institutes of Health were able to reduce their risk for seven different types of cancer by as much as 25 percent.
This included common—and deadly—forms of the disease like colon and breast cancers, as well as endometrial cancer, kidney cancer, myeloma, liver cancer, and non-Hodgkin lymphoma.
* * *
Updated federal guidelines for physical activity recommend that people should aim for two and a half to five hours per week of moderate-intensity activity or 75 to 150 minutes per week of “vigorous activity.”
Sous vide chicken and sautéed sugar snap peas. This meal is part of a ketogenic diet.
From The Journal of Nutrition:
Recently, ketogenic diets have received substantial attention from the general public and nutrition research community. These very-low-carbohydrate diets, with fat comprising >70% of calories, have been dismissed as fads. However, they have a long history in clinical medicine and human evolution. Ketogenic diets appear to be more effective than low-fat diets for treatment of obesity and diabetes. In addition to the reductions in blood glucose and insulin achievable through carbohydrate restriction, chronic ketosis might confer unique metabolic benefits of relevance to cancer, neurodegenerative conditions, and other diseases associated with insulin resistance. Based on available evidence, a well-formulated ketogenic diet does not appear to have major safety concerns for the general public and can be considered a first-line approach for obesity and diabetes. High-quality clinical trials of ketogenic diets will be needed to assess important questions about their long-term effects and full potential in clinical medicine.
Public health officials for years have urged Americans to limit consumption of red meat and processed meats because of concerns that these foods are linked to heart disease, cancer and other ills.
But on Monday, in a remarkable turnabout, an international collaboration of researchers produced a series of analyses concluding that the advice, a bedrock of almost all dietary guidelines, is not backed by good scientific evidence.
“I don’t mind dying. I just don’t want to be there when it happens.” –Woody Allen
Proton pump inhibitors (PPIs) are widely used in the U.S. to treat or prevent heartburn and ulcers. For example, omeprazole is the 6th most prescribed drug in the U.S. according to one source. PPIs reduce acid production by the stomach. Doesn’t it make sense that God or Nature gave us that stomach acid for a reason? Like to kill germs or aid the digestive process?
From the British Medical Journal:
Taking PPIs is associated with a small excess of cause specific mortality including death due to cardiovascular disease, chronic kidney disease, and upper gastrointestinal cancer. The burden was also observed in patients without an indication for PPI use. Heightened vigilance in the use of PPI may be warranted.
In general, women are a bit less likely to get cancer than men. But having type 2 diabetes and obesity negates that advantage.
“If you’re a woman with type 2 diabetes, you may be interested in a recent study done regarding obesitiy-related cancer risk. The CDC says that 40 percent of cancers in the U.S. are associated with being overweight or obese. These include cancers of the breast, gallbladder, liver, thyroid, kidneys, uterus, pancreas, upper stomach, colon and rectum, ovaries, multiple myelomas, adenocarcinoma of the esophagus, and meningiomas.
When it comes to diabetes and obesity, the duo “seem to be partly overlapping risk factors for the development of obesity-related cancer”. This especially includes breast, prostate, and colorectal cancer in those with type 2 diabetes, according to study authors.”
Dr. David Gorski is a breast cancer surgeon. He’s looked at the scientific literature on the linkage between diet and exercises, and the risk of developing cancer.
Here’s his conclusion from a review at Science-Based Medicine:
“You can reduce your risk of cancer by staying active and exercising, eating a healthy diet with a lot of plant-based foods and minimizing intake of processed meats, limiting alcohol consumption (although I think the WCRF/AICR guidelines go a bit too far in saying that you shouldn’t drink at all if possible), and maintaining a healthy weight. (Of course, if you stay active and eat a healthy diet, maintaining a healthy weight will probably not be a problem.) Conceptually, it’s easy to do. In practice, as I’m discovering, it’s anything but easy.”
Jamesons Irish Whiskey Photo copyright: Steve Parker MD
It was just a few months ago we learned that you’ll die of cancer if you tipple. Well, a new study says you can counteract the carcinogenic alcohol with adequate physical activity.
A story at CNN tells us how much exercise it takes :
“Specifically, they looked at the impact of the recommended amount of weekly exercise for adults, which is 150 minutes of moderate aerobic activity. That includes brisk walking, swimming and mowing the lawn, according to the US Department of Health and Human Services. HHS also advises strength training for all major muscle groups at least twice a week.”
Diabetic Mediterranean Diet 