Article published in the Journal of the American Medical Association, Aug 2007, shows that diet has an important role in the prevention of recurrence in colon cancer patients.

Article published in the Journal of the American Medical Association, Aug 2007, shows that diet has an important role in the prevention of recurrence in colon cancer patients.

Diet has been shown to be an important factor for the prevention of first-time colon cancer. 2 large studies showed that a "western diet" with large amounts of red meat, sweets, and desserts, and refined grains increased risk of first time cancer. Large studies on the effect of diet on survival, and recurrence of cancer, in patients with treated advanced colon cancer have not been done until now. This population is of course more difficult for dietary intervention to have a major role, but in fact that is exactly what was found.

This study, published mid-August of 2007, looked at over 1000 patients who had been diagnosed and treated for stage III colon cancer. Generally this means that the cancer had already spread to the lymph nodes in the region. Treatment was done with surgery and chemotherapy, and then rates of death and recurrence of cancer were studied in long-term follow up in groups of patients with markedly different diets.

Diets were divided into two main types: the "prudent diet" with many fruits, vegetables, poultry and fish; and the "western diet" with more red meat, fat, refined carbohydrates and grains, and dessert.

Prudent diet

Rich in:

green leafy vegetables, yellow vegetables

cruciferous vegetables (broccoli etc)

legumes

fruit

light salad dressing

tomatoes

garlic

fish, poultry

fruit juice

whole grains

low fat mayo

wine

tea

Western diet

Rich in:

high fat dairy, low fat dairy

refined grains

condiments, regular mayo

red meat

processed meat

dessert

margarine

potatoes

butter

french fries

eggs

nuts

sugar beverages

beer

Items above that potatoes and tomatoes showed some over-lap and were generally in higher amounts in both types of diets. It should also be noted that patients in the prudent diet ate significantly less sugared beverages and french fries. Another thing to note from the data is that when the researchers compared the actual foods in the patients who were separated into different groups, there was very little overlap, so patients who ate the "western diet" really seemed to like those foods!

Not surprisingly, patients who ate the "prudent diet" tended to be more active, have less body weight for their height, and were less likely to smoke. However, the researchers did look at the results, and did adjust for many risk factors including weight, exercise, smoking, and so forth, but still found an independent dietary effect.

The results?

When looking at the rate of either cancer recurrence OR death, patients who ate the most (top 1/5th) of the "western diet" foods had 3.25 times more risk of cancer recurrence or death compared to patients who ate the least (bottom 1/5th) amount of "western diet" foods! The possibility of these results being due to chance was less than 1 in 1000.

The increased rate of death wasn't from patients who found out they had a recurrence and thus started eating poorly either. If a patient had a recurrence or died within 90 days of completing the questionnaire, their results were excluded.

Perhaps that was not so surprising, that a poor, high-fat, westernized diet would increase the risk of recurrence.

There was a surprise in this study though, which is that the "prudent diet" - characterized by high fruits and vegetables, whole grains, chicken, and fish, showed no protective effect against recurrence of cancer or death. It is important to note that the researchers were looking at results within the prudent diet group, meaning they were looking to see if that people in this group ate way more fruits and vegetables, and the other "prudent foods", would they have more protection compared to patients who ate less of those foods (but still ate mostly well).

In my reading of the study, it did not seem to compare rates of cancer recurrence between the western and prudent diet groups.

In a nutshell, they found that if patients were eating a westernized diet, if they ate more of the western foods, they were at increased risk.

If patients were eating a "prudent diet", and they ate more of the prudent foods, they were not more protected than patients who still ate that diet, but less of those foods.

Confusing, but the take home is simple: less of the high fat, red meat, processed meat, refined grains, and other western foods is likely better.

So in combination of the steps that I wrote for prevention of first-time colon cancer:

1. General blood chemistry screen and comprehensive metabolic profile to assess for iron deficiency, other problems. History and physical exam to assess for any significant immune system issues.

2. 25-OH vitamin D3 blood test: this is vital in my opinion to help determine ideal dosage of vitamin D3, if any, with the goal of immune system optimization and colon cancer prevention.

3. Provoked metal detoxification challenge: in those over 40 to assess for significant increased body burden of toxic metals. This is much better in my opinion than a simple blood mercury and blood lead, which are usually only indicative of acute exposure. Remember, many heavy metals are likely human carcinogens.

4. Consider folic acid, calcium, green tea, curcumin, diet rich in fruits and vegetables, diet low in red meat and preserved meats. The ideal plan is also based on the blood chemistry and metabolic profile, as this can give hints as to the ideal type of diet for a particular person’s metabolism.

5. Aerobic exercise.

6. Crohn’s / Ulcerative Colitis patients: Screen for food sensitivities (IgG) / allergies (IgE) through either blood ELISA/RAST test. Food elimination / challenge testing may be done to determine symptoms that may be provoked by positive foods. Groups with inflammatory bowel diseases, such as Crohn’s and ulcerative colitis, are at known elevated risk for colon cancer.

Any intravenous or invasive procedure carries risks. Many chronic conditions, including those with unclear singular or multifactorial causes, are controversial in both diagnosis and treatment standards. Be sure to seek qualified second opinions. Your family MD is a good choice, as are “Functional Medicine” MDs. Other ND’s are excellent as opinions and therapeutics vary.

The opinions expressed on these pages is representative of our professional experience and opinion. These may differ from what is considered standard or usual care.