Nutritional Influences on Illness
by Melvyn R. Werbach, MD

Treating Cancer with Diet and Supplements
About 30% of cancers in developed countries can be traced to diet. Obesity increases the risk of cancers of the esophagus, colorectum, breast, endometrium, and kidney.¹ In one large cohort, for example, the heaviest members had death rates of all cancers combined that were 52% higher (for men) and 62% higher (for women) than the rates in men and women of normal weight.²

Alcohol causes cancers of the oral cavity, pharynx, larynx, esophagus, and liver, and slightly increases the risk of breast cancer. For several types of cancer, adequate fruit and vegetable intake probably lowers the risk. Many other dietary factors, including meat, dietary fiber and specific nutrients, appear to influence risk, although their contribution is not yet clear.¹

Because of the obvious links between diet and cancer, many investigators have designed dietary programs for the treatment of cancer, often in combination with standard treatments. Commonly these diets attempt to enhance the benefits of a therapeutic diet by adding supplementary doses of specific nutrients. Most have reported good results.

For example, starting in 1989, Hoffer and Pauling³ have reported their findings from an ongoing informal clinical trial of a combined diet and supplement regimen added to standard treatments. Generally, their program consists of dietary instructions to reduce red meats, increase green vegetables, and avoid sugar, coffee, cocoa and milk products. Nutritional supplements consist of:

• Vitamin C (mixture of ascorbic acid, sodium ascorbate and calcium ascorbate): 12 g or to bowel tolerance
• Vitamin B3 (niacin, niacinamide): 1.5-3 g
• Vitamin B6 (pyridoxine): 250 mg
• Folic acid: 5-10 mg
• Other B vitamins: 25 or 50 times the RDAs
• Vitamin E: 800 IU
• Beta carotene: 25,000-50,000 IU
• Selenium: 0.2-0.5 mg
• Zinc sulfate: 220 mg
• Calcium, magnesium or a multimineral tablet (sometimes)
• Coenzyme Q10 300 mg (later modification)

A progress report published in 1993 noted that 101 out of a group of 134 patients who entered the study followed the program. For analysis, survival of study patients who failed to follow the program (controls) was compared to survival of those who followed it. Forty percent of those who followed the program were judged to be excellent responders, with survival times after study entry of at least 5 years, while 60% were good responders, with mean survival times about 4 times that of the controls.⁴

By 1996, 33 of the 101 patients were alive, and Hoffer estimated that about 30% of the original group would survive 10 years, confirming the estimated survivals from the initial Hoffer and Pauling report. In addition to increasing survival, the regimen appeared to enhance the quality of life and reduce the side effects of radiation and chemotherapy.⁵

The contribution of vitamin C supplementation to survival appeared to be especially important. Unless patients ingested the high dosages of the vitamin for at least 2 months, their prognosis was very poor.³ However, the efficacy of the program was not attributable to vitamin C alone, as only about 10% of patients who only ingested supplemental ascorbate were judged to be excellent responders versus the 60% of patients on the full regimen.4 When coenzyme Q10 was later added to the program, results further improved by about 10%.⁵

Also, numerous formal studies, many of them double-blind, have reported efficacy in treating cancer using various combinations of supplemental nutrients without making dietary changes. Often standard (radiation and chemotherapy) or experimental therapy (hyperthermia and immunotherapy) were administered concurrently.⁶ These include studies of cancers of the bladder,⁷ breast,⁸ esophagus and stomach,^9,10 and lung.¹¹

There has been concern that antioxidants, by destroying free radicals generated during therapy, may protect cancer cells against death and thus reduce the efficacy of radiation and chemotherapy. However, no published data have supported this hypothesis.⁶

References
1. Key TJ et al. Review: The effect of diet on risk of cancer. Lancet 360:861-8, 2002
2. Calle EE et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US Adults. N Engl J Med 348(17):1625-38, 2003
3. Hoffer A. Orthomolecular Medicine for Physicians. New Canaan, CT, Keats Publishing, 1989
4. Hoffer A, Pauling L. Hardin Jones biostatistical analysis of mortality data for a second set of cohorts of cancer patients with a large fraction surviving at the termination of the study and a comparison of survival times of cancer patients receiving large regular doses of vitamin C and other nutrients with similar patients not receiving these doses. J Orthomol Med 8(3):157-67, 1993
5. Hoffer A. How to live longer and feel better — even with cancer. J Orthomol Med 11(3):147-67, 1996
6. Prasad KN et al. Review: Scientific rationale for using high-dose multiple micronutrients as an adjunct to standard and experimental cancer therapies. J Am Coll Nutr 29(5):450S-463S, 2001
7. Lamm DL et al. Megadose vitamins in bladder cancer: a double-blind clinical trial. J Urol 151(1):21-6, 1994
8. Lockwood K et al. Apparent partial remission of breast cancer in "high risk" patients supplemented with nutritional antioxidants, essential fatty acids and coenezyme Q10. Mol Aspects Med 15 Suppl:s231-40, 1994
9. Taylor PR et al. Effect of nutrition intervention on intermediate endpoints in esophageal and gastric carcinogenesis. Am J Clin Nutr 62(suppl):1420S-3S, 1995
10. Wang GQ et al. Effects of vitamin/mineral supplementation on the prevalence of histological dysplasia and early cancer of the esophagus and stomach: results from the General Population Trial in Linxian, China. Cancer Epidemiol Biomarkers Prev 3(2):161-6, 1994
11. Jaakkola K, et al. Treatment with antioxidant and other nutrients in combination with chemotherapy and irradiation in patients with small-cell lung cancer. Anticancer Res 12:599-606, 1992

If you are interested in how diets and nutrients can help patients improve their health, you will want a copy of Dr. Werbach's Textbook of Nutritional Medicine. For information, or a free brochure on all of his books, contact Third Line Press Inc., 4751 Viviana Drive, Tarzana, California 91356, USA. (Phone: 818-996-0076; Fax: 818-774-1575; internet: http://www.third-line.com; e-mail: tlp@third-line.com).

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