Hello, this is Dr. Jake Psenka from Longevity Medical Health Center in Phoenix Arizona, and if you didn’t know, February was National Cancer Prevention month.
I’ve been working with people to help prevent and treat cancer for almost 20 years, and I want to let people know what they can do to reduce their risk of contracting this disease. Preventing cancer is much easier than treating cancer and doesn’t really require any major shifts in lifestyle. I’ve found that many people know they should try to be healthy, but really aren’t sure how to do that. This short article will cover the basic concepts that people should know if they are looking to prevent cancer. This article is only the tip of the iceberg, and more information is available on my website HERE.
Research estimates that about 85% of cancers are preventable. This means that only about 15% are inherited. 85% is a huge number, and to put this in perspective consider that there were an estimated 1.8 million people diagnosed with cancer in the US in 2018. A prevention rate of 85% on 1.8 million people comes out to a whopping 1.4 million people who could have potentially not have been diagnosed with cancer. That’s a pretty substantial amount, imagine this on a global scale where over 9 million people die of cancer annually.
So, if it's not genetics, what does increase your risk of getting cancer? Research has shown that toxic environmental exposures and unhealthy lifestyle habits are the main things which increase a person's risk of developing cancer.
Some of these risk factors should be well known to just about everyone at this point, such as cigarette smoking, or excessive sun exposure. So, if you're a still a smoker it’s time to stop. Seek some help and quit for good. It really is never too late to quit. Also, if you're still smearing yourself with baby oil and lying in the sun for that deep dark tan, it's time to stop and buy a wide-brimmed hat.
Some of the environmental risk factors such as radiation exposure, air pollution created by vehicle exhaust or incinerators, pesticides, and polluted drinking water can be tricky to avoid, but with a little effort, even their effects can be minimized. The first thing to do is to determine whether or not these things present an excessive risk to you and your family. Buy a radon test kit at your local hardware store to see if the level of radiation in your home is safe. Have your water tested to make sure it's not contaminated with excessive amounts of heavy metals or chlorine. Just assuming you don't have a problem or that someone else is looking out for you isn't in your best interest. If you don't know you have a problem, you won’t know to fix it.
If you’re concerned about the quality of the air in your home, there are companies that will come and assess your indoor air for environmental and chemical toxicities. However, you could just purchase a high-quality air filter that removes both chemical and particulate matter from the air for probably less than the air quality testing costs. In my opinion, if you live in an urban area it's probably a really good idea to have a high-quality air filter in your home. Those little filters that you're supposed to change every 30 to 60 days on your HVAC system are very unlikely to be adequate.
Like the environmental risk factors, the unhealthy lifestyle risk factors seem pretty obvious. Concepts such as consuming a healthy and nutritious diet, getting regular exercise, avoiding excessive weight gain, and minimizing stress levels seem like common sense. However, in my nearly 20 years of helping people fight cancer, I’ve found that there are still a lot of questions and confusion regarding lifestyle risk factors and how to modify them.
Let's start with your diet. The main goals of diet are to:
Attain and maintain a healthy weight
Adopt a primarily plant-based diet that is low in red and processed meats
And minimize your intake of simple sugars and refined carbohydrates.
So, let's define what is a healthy weight is; according to the US Dept. of Health and Human Services, the best measure of a person’s healthy weight is the BMI, or Body Mass Index. Your BMI is a calculation based on your height and your weight and thankfully there are lots of free online body mass index calculators available on the internet, so you really don't need to learn any new math.
Normal weight is generally considered to be a BMI of 18.5 to 24.9. I say generally because there are some who believe the BMI range should be slightly different. If your BMI is less than 18 you could be too lean, and if your BMI is greater than 25 then you might need to lose some weight. A BMI of greater than 30 defines obesity.
The BMI isn’t the end all be all assessment of a person’s weight. Where a person carries their weight, like the “apple-shaped” body type, may influence risk independent of a person’s BMI. Also, people who have less common body types might experience some problems with their BMI. For instance, my BMI is calculated at being greater than 24. I’m pretty sure this has more to do with me being 6’6” and not with being overweight.
Despite its shortcomings, the BMI is the most accessible and easy tool for understanding where your weight is at. Additionally, much of the research concerning weight and cancer risk has focused on the BMI. So, for the majority of people out there, I think that using the BMI as a general tool and attaining a BMI of 18 to 25 will be advantageous.
It has also been suggested that using a person's waist measurement may be a good indicator of a healthy weight. To be clear, I’m talking about W A I S T, not W A S T E. A waist greater than 35” for a woman, or 40” for a dude could signal a need for weight loss.
Obesity is related to increased risk for many cancers such as esophageal, stomach, pancreatic, colon, prostate, breast, gallbladder, and ovarian cancer. The role that obesity plays in promoting cancer growth is complex and multi-factorial, but in a nutshell, the problem with obesity is that it causes excessive chronic inflammation in the body. This chronic inflammation causes all sorts of problems by dysregulating energy metabolism, stimulating genetic changes associated with malignancy, and the promotion of growth stimulators such as insulin and Insulin-like growth factor that trigger abnormal cells to grow. Additionally, the chronically elevated insulin levels seen in obesity can also increase hormone bio-availability creating another risk factor for breast and prostate cancers.
OK, we’ve discussed the environmental risk factors for cancer, the generally accepted measurement of healthy weight, and you know how to figure it out your own BMI with no doctor needed. We also discussed the ways that extra weight and obesity can increase your cancer risk, so let’s talk about how to eat to attain and maintain a healthy weight.
I’m sure everyone has heard of a plant-based diet, and you might be asking yourself exactly what that is. Is it a Whole Foods Plant Based Diet, a vegan diet, or is it a plant-based Mediterranean keto paleo hybrid eating plan? Let’s not get carried away. A plant-based diet is just what it sounds like, a diet that consists of mainly fresh vegetables and fruits, nuts, whole grains, and lentils. Also, adopting a plant-based diet doesn’t mean you can never have animal products or birthday cake again. To get the best of a healthy diet it’s important to remember that it’s what you do most of the time that counts.
You might be wondering what’s the problem with animal products anyway? Well, there’s a couple. First, you may want to consider how that animal was raised and processed. Was it a steer given growth hormones and antibiotics, fed a corn-based nutritionally deficient diet and raised in a high-density factory farm? Or was it a cow raised outside field eating grass? I’ll take the later, as I can’t imagine that the prior creating healthy animals nor adequately feeding healthy humans.
Another concern about animal products is the type of fat that they contain. Animal products, particularly red meats, are typically rich in the pro-inflammatory omega 6 fatty acids and don’t contain much of the anti-inflammatory omega-3 fatty acids. Both the 6’s and 3’s are considered essential fats, meaning that the body must have these fats in order to be healthy, but cannot make them on their own. They must be consumed in the diet. The problem occurs when these fats are consumed in a non-balanced way.
Research suggests that before our dependence on processed foods humans had an Omega-3 to Omega-6 ratio of roughly one to one. Modern day people have a ratio ranging from 1:10 to 1:25. This imbalanced ratio creates excessive inflammation in the body and has been shown to promote the growth of cancer cells, inhibit brain development, and even promote violent behavior. Limiting your intake of animal products can help to correct this ratio.
So, limiting animal products can help lower the ratio to help reduce unwanted inflammation. It’s important to know that red meats are not the only place Omega-6’s occur in our diets. Many nuts and seeds also contain Omega-6 fats, and incredibly it has been estimated that up to 20% of the total calories in a typical American diet are derived from soybean oil, which is a very rich source Omega-6 fatty acids.
An easy way to help correct the Omega-3 to Omega-6 ratio is to incorporate more Omega-3 containing foods in your diet, such as fish like salmon, flax and chia seeds, nuts, and vegetables such as leafy greens and brussels sprouts. Many people elect to take a fish oil supplement, which is also not a bad idea. If you’re going to take fish oil, make sure you choose a brand that has processed the oil so that it doesn't contain pollutants.
Numerous studies have confirmed that correcting this ratio- either by reducing the 6’s or increasing the 3’s has profound effects on human health- including the reduction of cancer risk.
A second concern about animal products is the high levels of saturated fats they contain. Some research as found in increased risk of breast, ovarian, and lung cancers with higher saturated fat intakes. Do US Department of Health and Human Services suggests no more than 10% of your total calories come from saturated fats, while the American Heart Association suggest no more than 5 to 6% of total calories. So, who do you believe? I say consider them both and shoot for the middle, like 7% or so.
Typically, one gram of saturated fat contains 9 calories. So if I'm eating a 2000 calorie a day diet, 7% of that is 140 calories. 140 calories divided by 9 equals 15.5 grams of saturated fat per day for me.
There still isn’t a complete consensus on why saturated fat is bad for cancer. However, some recent research had found that high intakes of saturated fats could promote cancer growth and metastasis. Early research on this subject used mouse-based models of oral cancer and found that mice fed diets containing high levels of saturated fats had more cancer spread and larger tumors. Since that time additional research has shown a correlation between saturated fat intake and growth promotion of breast, prostate, and liver cancers.
OK, one more thing and then I'll stop bashing on meat. Many people like to grill their meat, and in doing so compounds called polycyclic aromatic hydrocarbons are created. These polycyclic aromatic hydrocarbons cause cancer, and they are the same nastiness that makes air pollution and emissions so toxic. These compounds can also be found in contaminated water. It's a good practice to try and avoid these compounds whenever you can. Interestingly, green tea has been found to be able to offset some of the negative effects of polycyclic aromatic hydrocarbons, so drink up. Cheers!
As far as eating animal products goes, think about making the animal products in your diet more of a side dish rather than the main course. And, when you do eat them buy the highest quality, most nutritious animal products you can find. And, if you're grilling, try not to turn your food into charcoal.
FRUITS AND VEGETABLES
Another question I get asked a lot is how many fruits and vegetables should a person eat in a day? Well, the Centers for Disease Control recommends 1-2.5 cups of fruit and 2-4 cups of vegetables daily. And, the CDC estimates that only 1 in 10 adults meet this recommendation. Fruits and vegetables are essential to good health because of the nutrients (like omega-3 fats), vitamins, minerals, and fiber they contain. Having a good intake of these vitamins and nutrients are required for good health because they allow the body to run efficiently.
There are something like 2 million chemical reactions that occur in the human body every second. These reactions allow all sorts of important things to happen such as proof-reading new DNA during cell division, fighting infections, providing adequate maintenance and upkeep in tissues, and even things we take for granted, like breathing. Nutrients and vitamins are often needed for chemical reactions to occur properly. If the nutrient or vitamin supply is limited or missing, the reaction might not happen as required. Having a chronic deficiency of vitamins and nutrients may impair many important reactions and functions required for good health.
Recent research supports this notion. A newer study found that a higher intake of fruits and vegetables was associated with a substantial reduction in breast cancer risk. In this study, researchers examined data collected from over 180,000 women. They found an 11% reduction in breast cancer risk for women who consumed over 5.5 servings of fruits and vegetables daily. Moreover, the intake of fruits and vegetables was associated with a reduced risk of a more aggressive type of breast cancer. The benefits of consuming fruits and vegetables were strongest after 8-12 years, meaning that it’s important to regularly include these foods into your diet.
In the study, a serving was defined as one cup of raw leafy vegetables, a half cup of raw or cooked vegetables, or a half cup of chopped or cooked fruits. That is not a lot of produce. One big salad can pretty much meet a person’s requirement for the day.
The evidence of benefit isn’t limited to breast cancer. Most other cancer types, as well as other chronic diseases such as diabetes and heart disease, can have their risk reduced with regular consumption of fresh fruits and vegetables.
As always, I recommend that people consume the highest quality of produce. Fresh is nearly always better than frozen, raw lightly sautéed is mostly better than boiled to death, and organic and pesticide-free is better for long term health than treated plant products. You might want to check out the “Dirty Dozen” and “Clean 15“ lists published by the EWG to see which fruits and veggies are the cleanest and the dirtiest.
Far and away the most common question I hear about diet and cancer has to do with sugar. Does sugar feed cancer? Do you need to be completely sugar-free when fighting cancer? Right now, there isn’t sufficient evidence to say for sure that high sugar diets will cause cancer in everyone, or that high sugar diets will always accelerate cancer growth. In fact, there are many doctors who treat cancer that don’t believe there is a connection between what a person eats and cancer risk or cancer progression. I’m always dismayed when I hear from a patient how Dr. So and So is handing out candy and coca cola in their IV room. While there isn’t agreement about the potential role of sugar and carbohydrate intake in cancer, there are some pretty interesting findings and facts about sugar that I think people should be aware of.
First off, there’s a reason we all love sugar. We’re all hard-wired to love sugar and carbohydrates because they present the fastest way for our cells to produce the energy we need to live. Cancer cells make use of a different energy production pathway that most of our normal cells. Cancer cells use something called aerobic glycolysis to produce the energy they need, this is sometimes referred to as the Warburg Effect after scientist Otto Warburg who first described this. Normal cells typically use something called oxidative phosphorylation to produce energy. Both use glucose, aka a simple sugar, as the fuel to produce energy. The difference between the two is how efficient they are. Energy production via aerobic glycolysis isn’t efficient at all compared to oxidative phosphorylation. In order to make enough energy using aerobic glycolysis cancer cells need to burn about 18 times more glucose. Therefore, they have a high demand for sugar. This is a generalization, as not all cancers exclusively use aerobic glycolysis and some cancers retain the ability to use oxidative phosphorylation. However, it is a safe assumption to think that the high energy demands of most cancers require lots of sugars to fuel their growth, and therefore limiting sugar intake can potentially reduce the available energy.
And what do those cancer cells do with their energy? They grow, they reproduce, they spread, and they become resistant to treatment. All things we would rather not have to deal with. Consuming a high-sugar diet when cancer is present is probably not too far from being like an all you can eat buffet for the cancer cells.
And, as I pointed out earlier, there is a well-studied connection between obesity and cancer. There’s also a solid connection between excessive carbohydrate intake and an increased risk of obesity. Less sugar, less obesity, less cancer.
Consuming sugar and carbohydrates also causes the body to produce a hormone called insulin. Insulin is used to help cells move sugar found in the bloodstream into the cells where it can be turned into energy. Consuming excessive carbohydrates causes an excessive amount of insulin to be released into the body. Too much insulin isn’t a good thing, because insulin is a pro-inflammatory growth promoting hormone and higher blood levels have been shown to increase the risk for several cancers, such as prostate cancer where men with the highest insulin levels had a 2.5x risk of developing the disease. It’s not just prostate cancer either, many cancers have shown accelerated growth when exposed to high insulin levels. For some cancers, high insulin levels seem like rocket fuel, like ovarian cancer, where risk can be increased 45-times-fold with chronically elevated insulin levels.
So again, excessive consumption of sugar and carbohydrates doesn’t seem like a smart idea when the effect it produces is a strong growth signal combined with high-octane metabolic fuel.
Everyone knows they should exercise. Exercise is vital to human health. A quick look in the mirror will confirm this, long arms and legs; we were built to move. Movement has been an important part of the human experience for as long as there has been a human experience. Regular exercise can improve almost every aspect of human health, both mental and physical. What does exercise do to prevent cancer? Studies examining the relationship between exercise and colon cancer found up to a 24% risk reduction for people who actively exercise. In breast cancer, the risk was reduced by up to 16% and post-menopausal women were found to benefit from exercise the most. Endometrial cancer risk can be reduced to 20%, and the list doesn’t stop there. Esophageal, stomach, kidney, head neck, and bladder cancer risk can be reduced with exercise, as can myelomas and some leukemias.
Exercise can certainly help to reduce obesity and weight gain, which as I covered are risk factors for cancer. There are other ways in which exercise reduces cancer risk. Exercise can lower the number of circulating hormones such as insulin and estrogen, it acts to stimulate the immune system, reduces inflammation, and promotes gastric emptying which helps promote detoxification.
In my opinion, there are other benefits to regular exercise which also help reduce the risk of cancer. One is detoxification. Although I’m not really a fan of the ubiquitous “detox,” I do think that enabling the body to remove excess metabolic waste and environmental toxins is important. Your largest organ of elimination is your skin. On average a person can lose between 0.8 and 1.6 liters of water per hour when exercising. For comparison, a bike water bottle holds 0.7 liters. Water isn’t the only thing that gets excreted out of the skin when you sweat, nasty things like heavy metals and bisphenol-A (BPA) are also eliminated in sweat.
Further, and importantly, regular exercise can reliably reduce stress and anxiety. In today’s world excess stress and anxiety is a leading health problem. Nearly every person I see in the clinic has some concern regarding their stress levels. This most frequently manifests as problems falling asleep, mostly due to racing thoughts. The problem with excessive stress is bigger than just keeping you from falling asleep. Elevated stress levels are responsible for increased risk of many diseases, and although there doesn’t seem to be a lot of research on the topic, my bet is that excessive stress can increase the risk of cancer too. Participating in regular exercise is one of the easiest, not to mention the most natural way to fight stress.
It has been determined that people need about 2.5 hours of exercise per week to get the benefits. That’s less than 30 minutes per day. Further, those minutes don’t really have to be in a single time frame, it could be broken up into 10 minutes of exercise three times per day. It seems to me that no matter how busy a person is, finding 30 minutes per day is not an insurmountable task.
There are a couple of reasons beyond time constraints that people find it difficult to exercise. Accountability is a big one. It is very easy to talk yourself out of going to the gym. The way around this it to tell that friend of yours that also needs to work out that you’ll meet them at the gym or the trailhead. We all have that friend. You’ll be much less likely to bail if you know that your pal is there waiting for you. Second, do something that you like. It’s tough for me to get excited about going to the gym to spend an hour on the Stairmaster, but I’m always ready to hike up Piestewa Peak. Exercise doesn’t have to be a chore. Find something that you enjoy doing and you might start looking forward to your exercise time!
So there you have it, a basic primer on the simplest things that a person can do to prevent cancer. Hopefully, this will shed a little light on the subject for people who are interested in preserving their health. This isn’t an all-inclusive list, it just covers the basics of what is known about cancer prevention. If you’d like more information on cancer prevention, treatment, and health improvement please check out my blog or call my office, Longevity Medical, at 602-899-4070.
Thanks for reading.
Jake Psenka, ND
PS: Here are a couple of links to articles/research that may be of interest: