What Really Causes Cancer? – How to know and prevent

March 25, 2022

What really causes cancer?


1. Radiation can be a trigger for head and neck cancers

High dose radiation can cause cancer to develop.

Cancer is common in survivors of exposure to Chernobyl. After World War II, survivors of Hiroshima and Nagasaki developed multiple cancers years decades after the disaster.

Cancer patients who were treated successfully with high dosed radiation for their nose and throat cancers may suddenly see new tongue cancers after several years.

Why is this so? Repeated damage.

During radiation, cells die and regrow repeatedly. This repetitious death and growth cycle can predispose one to an increased risk of other cancers.

Even low dose ionizing radiation IR can encourage new blood vessel formation and wayward surface cell movement, all of which are cancer-promoting.

There is also a loss of oxygen during radiation. Cancer cells usually grow fast and multiply fast.

Fast tumor growth means the cells will crowd each other out, meaning there is less oxygen for all the cancer cells. The existing oxygen supply suddenly becomes inadequate. This lack of oxygen will change the tumor metabolism towards one that favors and protects cancers.

Lack of oxygen will change the immune system into one that no longer destroys cancers, but instead, “protects” cancers from immune destruction.

When oxygen is low, there is a tumor signal that increases. This signal is called hypoxia (hypoxia - means "low oxygen") inducible factor (the official scientific name is HIF-1 alpha). Increased HIF-1 alpha, is an important trigger of cancer. HIF-1 alpha increases and encourages even more tumor growth and multiplication.

2. Smoking is a cause of many cancers, not just lung cancer

The chemicals in the smoke can damage our genes and cause defects or mutations. These mutations can cause cancers. Aside from the mutations, there is also the repeated cell damage that I was talking about when we discussed radiation. Repeated damage to the cells that line our airways, can cause a cycle of damage- followed by - cell recovery, and so on. Cell recovery-damage-cell recovery. After a while, the damage continues and the cell recovery fails. Then, cancer is born.

3. Alcohol, the most ignored cancer risk factor

Surprisingly, MANY PATIENTS DO NOT REALIZE that alcohol can cause cancer. Too much media hype is placed on the health benefits of red wine. What they fail to advertise is the cancer-promoting effects of the alcohol itself.

By the same-damage -recovery-damage-recovery cycle, cancers can develop.

Therefore, anything that comes in contact with alcohol, are prone to developing cancers.

This is why there are certain “drinker’s cancers”. What are these?

Cancers of the nasal passages, throat, tongue, tonsils, esophagus, stomach, and liver, are all common cancers of drinkers.

Alcohol can also damage the bone marrow, so blood cancers like leukemias, are also seen in the offspring of both male and female drinkers.

So much so, that men, as well as women, should avoid alcohol if they are planning a pregnancy.

4. Hormone replacement therapy, oral contraceptive pills can be risky

Birth control pills and hormone replacement therapy for women under age 55 can cause one to have a higher risk of female cancers (breast and uterus cancers).

5. Infections- HIV, Hepatitis, Human Papilloma Virus- more than just a bug!

Liver cancer risk is higher in people who have a history of liver disease, alcoholic hepatitis, and viral hepatitis. By the same token, the repeated cycling between alcohol or viral damage of the liver cells, alternating with periods of cell recovery, can cause new cancer in the long run.

Human papillomaviruses can cause head and neck cancers, and cervical cancers. HIV or human immunodeficiency viruses also predispose to cancers.

6. Low immune system - a risk factor for cancer

A poor immune system can lead to higher risks of causing new cancers. Kidney and liver transplant patients often have to take immune suppressant drugs, in order to prevent rejection of their newly transplanted organs.

Unfortunately, this also comes at a price. Increased vulnerability to infections, and increased long term risk of developing cancers.

Patients with autoimmune disease, on chronic immunosuppressive drugs, are also at risk of developing tumors. People with the human immunodeficiency virus (HIV) are also at risk of developing cancers like Kaposi's sarcoma, and Non-Hodgkins lymphoma.

7. Genetics/ Hereditary Family Syndromes are not as common as you think!

Hereditary cancers get a lot of news attention, but in reality, hereditary cancer is not very common.

Families might have a pattern of cancer in their family history. If the pattern is suspicious, one should seek genetic counseling.

We now have multigene testing available, but this is not for everyone.

Just because there are a lot of family members with cancer, does not mean that they are all hereditary.

See a genetic counselor first, before embarking on a potentially expensive but low yield genetic investigation.

8. Poor diets can increase cancer risks

In our society, overindulgence in glucose and carbohydrates is common, and this too can cause one to have higher risks of developing cancer.

A diet high in carbohydrates and sugar can make our pancreas respond by producing more insulin, to try and bring the glucose down.

Insulin can trigger tumor growth signals such as HIF-1 alpha (hypoxia-inducible factor) as well as triggers other growth signals like insulin-like growth factor 1, epidermal growth factor and all these will go back and stimulate the central growth factor, which is a hypoxia-inducible factor. (HIF-1α)

When there is a lot of glucose, glucose breakdown products accumulate, such as pyruvate and lactate.

Pyruvate and lactate can directly activate the tumor signal HIF-1 alpha, and increase acidity. Acidity can cause cancers to break off and metastasize.

Lactate, through a series of chain reactions, will slow down the main energy production in the cell (mitochondrial respiration) and boost the more primitive forms of energy production (glycolysis), as well as boost new blood vessel production (angiogenesis) to supply the tumor with a fresh blood supply.

This is the Warburg effect in action. By promoting the shift towards glucose breakdown, (glycolysis), can directly stimulate more and more pro-cancer steps.

9. Too many birthdays- Gene damage AFTER birth

As we get older, our genes develop damage and this damage makes us prone to higher risks of cancer

We have genes (tumor suppressor genes) that prevent cancer, and if aging makes these genes no longer able to do their job, cancer will develop.

Gene damage is not always a requirement to get cancer. Some normal cells become cancer even without gene damage, but they develop cancers after their tissue is irritated after exposure to chemicals or irritants (carcinogens).

10. Then there are ONCOGENES- genes that are pro-cancer

Oncogenes are pro-cancer genes that have a purpose, which is to change normal cells into cancer.

Oncogenes, can talk with tumors to reprogram cell metabolism, and stop DNA cell repair.

Oncogenes can increase glucose breakdown and feed even more glucose to feed cancers.

Oncogenes can increase tumor acidity and stimulate new networks of blood vessels to grow and supply blood to tumors, increasing their chances of survival.

Oncogenes can make one resistant to radiation therapy and cause cancers to become aggressive. Many aggressive head and neck cancers do not respond well to radiation. Often, these patients have pro-cancer genes or oncogenes, OR they might have abnormalities in their tumor suppressor genes.

 

11. Gut microbiome - the bugs in your stool

There is a growing interest in gut bacteria as a possible cause of cancer. Gut bacteria can trigger immune responses and worsen chemotherapy side effects. Gut bacteria can stimulate the HIF-1 alpha signals to encourage even more blood vessel formation and pro-inflammatory interleukins. Targeting gut micro-bacteria can help improve tolerance to chemotherapy.

12. Beware of supplements

We often think that vitamins can be a good thing. But too much vitamin supplementation can be harmful.

Vitamin D supplementation can decrease cancer risk, Too much Vitamin A might increase head and neck cancer risk. Moderation is best.

13. Iron overload

Can iron excess be a cause of cancer too?

People have an inherited condition that we call hemochromatosis, and are at risk of cancers, commonly, liver cancers and possibly other cancers.

Too much iron can interfere with the elimination of the pro-tumor HIF1α signaling. Excess body iron can, therefore, encourage more cancers.

To treat this condition, we remove excess blood on a regular basis. They also have to avoid iron-rich food as well as vitamin supplements that contain extra iron.

 

14. Disrupted circadian rhythm/sleep cycles

There is a link between disrupted sleep cycles and cancer.

The disrupted sleep can reprogram cancer cells to develop, survive under stress, and grow, divide and avoid the immune system.

Bottom line?

What really causes cancer? It isn't just one thing. Rather, a combination of possible causes, over a course of perhaps, many years.

Eat well, moderate use of potentially harmful substances, or better yet, avoid them. Sleep quality is important, avoid stress. Live in the moment. Quality of life is always better than quantity, but if you can have both, why not?

 

References

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Exploring the Link Between Cancer and Weight Loss:

March 14, 2024
Breaking Down the Fear  Ketogenic diets often result in weight loss. Cancer patients frequently lose weight. Does this mean that keto diets are harmful to use in cancer patients? Cancer and weight loss are two topics that often come hand in hand, yet the relationship between them can be complex and sometimes frightening. Weight loss, particularly unexplained or rapid, can evoke fear in many individuals, often signaling underlying severe health concerns. However, when it comes to cancer, weight loss can sometimes be one of the earliest signs of the disease. In today's blog, we delve into the connection between cancer and weight loss, unraveling why the latter often instills fear and how understanding this relationship can lead to better health outcomes. Understanding Cancer and Weight Loss: Cancer involves uncontrolled cell growth and abnormal spread of cells throughout the body. These invading cells affect various organs and systems and disrupt their normal function. Weight loss can be very subtle or profound depending on the type of organ invaded. As cancer takes root and establishes itself, it also spews out cytokines (unique inflammatory proteins) that also serve as signal messengers, signaling muscles to lose volume, resulting in a weight loss phenomenon known as cachexia. Cachexia is a complex syndrome. Inflammation is often at the root of this problem, of profound muscle wasting, generalized fatigue, and poor appetite, Why Are We Afraid of Weight Loss? Weight loss, in general, is often perceived negatively in society. There's a prevailing notion that thinness equates to health, beauty, and success, while weight loss may imply illness or a lack of control. However, when weight loss occurs without intentional dieting or exercise, it can be a red flag for underlying health issues, including cancer. In cancer, especially, the presence of weight loss is disturbing because we traditionally associate it with illness. Association with Illness: Unexplained weight loss is commonly associated with illness, particularly severe conditions like cancer. The fear of the unknown and the potential implications of such weight loss can be daunting for individuals. To be of "normal" weight is equated with health. Loss of Control: Weight loss, especially rapid or involuntary, can make individuals feel like they've lost control over their bodies. This loss of power can be unsettling and exacerbate feelings of anxiety or fear. Uncertainty: Weight loss without a clear cause can be perplexing and raise questions about what might happen within the body. The uncertainty surrounding the underlying cause can contribute to fear and anxiety. During chemotherapy, however, weight loss is inevitable because we are in a catabolic state. The active cancer is making us lose weight. The key is to control or snuff out the underlying cancer. Once you weaken the tumor, less cytokine release and less inflammation will follow. As this occurs, the "source" of the cytokine release will die, and weight gain should naturally recover. Therefore, loading up on carbohydrates to make us appear to be of "normal weight" is incorrect. Loading up on sugary treats will only strengthen the cancer and will only be counterproductive! Conclusion: The fear of weight loss, particularly in the context of cancer, is understandable, given the potential implications for health and well-being. However, by understanding the complex relationship between cancer and weight loss and challenging societal stigmas, we can accept some form of healthy weight loss during chemotherapy. We can learn to recognize unhealthy weight loss (loss of muscle mass) and differentiate it from healthy weight loss during a ketogenic diet (most of which is weight loss from fat and excess water). As long as one feels energetic, with normal blood parameters and no indication of significant liver or kidney failure, anemia, or marrow failure, then some healthy weight loss during chemotherapy or implementation of a ketogenic diet CAN be acceptable.

GINGER ALE DURING CHEMOTHERAPY

March 4, 2024
Are you still drinking "ginger ale" during your chemotherapy sessions? You know, those gleaming, chilled cans of sparkly soda that your cheerful chemotherapy nurse hands out along with your anti nausea pills?  The scent and the taste of ginger help nausea stay away. But did you know that your "ginger ale" contains no ginger? Worse, the HFCS high fructose corn syrup, a highly processed sugar, can do you more harm than good. And making your cancer cells really happy. Next time you go for your chemo session, ask for water instead. Or better yet, bring your own ginger-infused drink from home. Here is some background about ginger. For centuries, ginger has been used as a remedy for nausea and digestive issues, and some scientific evidence supports its effectiveness. Here are some examples. Morning Sickness: Pregnant women often experience morning sickness, and ginger has been traditionally used to alleviate these symptoms. Several studies have shown that ginger can reduce nausea and vomiting during pregnancy. For example, a meta-analysis published in the Journal of Obstetrics and Gynaecology Research in 2014 concluded that ginger supplementation significantly reduced the severity of nausea and vomiting in pregnant women without any significant side effects. Motion Sickness: Ginger is effective in reducing motion sickness. A study published in Aviation, Space, and Environmental Medicine 1986 found that ginger was more effective than a placebo in reducing symptoms of motion sickness. Subsequent studies have supported these findings, suggesting ginger can alleviate symptoms like nausea, vomiting, and cold sweating associated with motion sickness. Chemotherapy-Induced Nausea: Cancer patients undergoing chemotherapy experience nausea and vomiting. The Journal of Alternative and Complementary Medicine 2009 published a review that analyzed several randomized controlled trials and found that ginger supplementation could reduce the severity of chemotherapy-induced nausea. Postoperative Nausea: Nausea and vomiting are common after surgery. A meta-analysis published in the journal Integrative Cancer Therapies in 2012 found that ginger effectively reduced postoperative nausea and vomiting compared to a placebo. However, we need more research to fully understand its mechanisms and best dosage. Everyone responds differently, but ginger, in its natural form, is usually safe to take during chemotherapy. Just make sure its the real thing! Photo credit Dan Sorum @ unsplash

Welcome to all our new members

January 30, 2023
Welcome to all our new members

Getting Started On A Keto Diet

May 17, 2022
Getting started on the keto diet usually sounds like someone is trying to lose weight? When you add cancer to that recipe, it becomes a whole new ball game. Do any of these thoughts sound familiar? “ I want to fight my cancer , and I heard that this diet can help me heal “ “ I’m confused because the keto diet will make me lose weight” “I’m afraid to lose more weight.” “I can’t afford to lose weight! “ “When is weight loss just right, and when is it too much? “ Is there real hope for me? Over the past two decades, I’ve seen my share of cancer patients. Yup, the whole package - diagnosis, anxiety, chemo, radiation, hair loss, weight loss, and, failures. But, I also saw many patients who achieve clean CT scans, remission, happy news, hair growth, and of course, the coveted weight gain. I have my own collection of patients with stage four cancers, a few have actually reached their ten to twelve year anniversary with me. Most of them have made it past five years and some are in complete remission. Yes, stage four to stage zero! How did they do it? You may have come to this website, searching for answers. I wish that I could tell you all that I know, in one sentence, but I can’t. It usually takes me several office visits to educate my patients. For now, you can stick around, and try to absorb the knowledge from current posts. Take time to read through my past blogs. Signup for a keto conference. There is one coming up very soon. The MHS 2022 in Santa Barbara California. May 5 to 8. Read books, and more books. You might be surprised. Not all books are the same. Some are full of dense material, while some are mostly fluff. But eventually, you will find the right book for you. Join me in one of my subgroups. But you need to fit the profile and be past the beginners stage when you join. Or you might get bored! I do show up there from time to time, to break the ice. And by the way, when you are stuck and can’t find the answers you are looking for...you need to make your voice heard and post your questions. What if my cancer doctor doesn’t approve? If your cancer doctor doesn’t know much about the keto lifestyle, or about metabolic approaches to cancer, don’t lose hope. Try to educate them, Share your knowledge. Even if they are at first resistant, with time, some will marvel at your progress and will notice that you are doing better than their average patients. Finally... the number one question that shows up on my blog.... What diet is best for me? I’m so CONFUSED! “ Dr. XXX on YouTube said that a keto diet and weight loss is good for cancer, but another doctor YYY said the opposite, that I should eat, healthy carbs, more plants, fruit , avoid fat and protein, try to gain weight. “ Dr. WWW advocates a vegan diet, but Dr ZZZ said do a carnivore diet.... , help!!!! Let me know your thoughts in the comments below!

New drug for relapsed Glioblastoma, a deadly form of brain cancer

March 30, 2022
There is exciting news on the horizon for glioblastoma, which is a deadly form of brain cancer. Have you heard of activated T cell therapy? It is similar to the car-T cell therapies that you often hear about for blood cancers. Well, this form of therapy is now available for patients with brain cancers. The catch is, you must enroll in a clinical trial. It is not yet available to the public. To qualify, one must have glioblastoma, a form of brain cancer , and cancer must have relapsed after the first diagnosis. Patients who are interested are now able to ask for information about enrolment at the Cedars Sinai Medical Centre in Los Angeles. This trial will be classified under a Phase one type of clinical trial. The drug company, Kairos pharma is the sponsor. This exciting new therapy, otherwise known as KROS 201, is a form of activated T cell therapy. The patient’s white blood cells are first harvested. Blood is removed by a simple intravenous blood draw, and then sent off to the lab to be processed in a cell culture. In the lab, the white blood cells are primed by exposing them to small protein substances called cytokines. This process will in turn activate the white blood cells, specifically the killer T cells. Once activated, these cells can now fight cancer by inactivating cancer stem cells. The T cells are returned to the patient’s body by intravenous infusion. The link for enrolment is not yet available but do keep checking on www.clinicaltrials.gov

Mistletoe plus chemotherapy in non small cell lung cancer

March 25, 2022
Iscador, a type of mistletoe preparation was tested by a medical team in Israel alongside conventional chemotherapy in the treatment of patients with advanced non small cell lung cancer. Although no improvement in survival or quality of life was noted,non hematological side effects from the chemotherapy and hospitalizations were less in the group which received the mistle toe preparation. Possible yet unproven mechanisms of action include improvement of immune function via increasing the number of NK natural killer cells as well as improve the function of Tumor Necrosis Factor Alpha. Fever which is also a noted side effect of this preparation has been described prior to spontaneous regression of certain cancers such as melanoma implying a possible role of immunotherapy in the fight against cancer. No randomized trials on cancer patients have yet been published. 

Brain cancer – Challenges with the ketogenic diet

March 25, 2022
We made little progress in the way of survival in the treatment of malignant brain tumors, specifically the deadly glioblastoma multiform. Despite aggressive surgery followed by radiation therapy and precautionary chemotherapy, they relapse early and survival is measured in months. Patients rarely survive beyond a year. Alternative therapies abound with few successes. Some patients attempt to enroll in clinical trials in search of new drugs that might make a difference in their survival.  There is a biologic treatment available. It is the monoclonal antibody called Bevacizumab. It supposedly controls the growth of blood vessels that supply nutrition to the brain tumor. Shrinking the blood supply supposedly starves the tumor. Very exciting, but nonetheless isn't a cure. Long term survivors still remain a rarity. There is mounting interest in metabolic basis of cancer development. In this respect, I do feel that ketogenic diets have potential benefit in brain cancer patients. The role of sugar and carbohydrates in the progression of brain tumors is interesting. Since most patients also are on steroids to improve brain swelling. It is also bad for them because this also increases their blood glucose. I wonder, if we are indeed adding fuel to the fire. A few case reports of brain tumor patients who were offered the ketogenic diet showed that some tumors stopped growing while others improved their survival. Notably, upon discontinuation of the diet, the tumor was noted to again progress, only to regain control upon reinitiation. Currently there are 4 clinical trials ongoing in the United States involving the ketogenic diet in the treatment of various forms of cancer. Another is ongoing in Germany. More clinical trial participation is desperately needed if we are going to move ahead and forge any progress with this deadly cancer. =

Lonsurf, newly approved colon cancer drug

March 25, 2022
Three weeks ago I got word that another new chemotherapy drug has been approved for the treatment of colorectal cancer. Ideal candidates for this drug are patients who failed previous chemotherapy involving one of the following drugs: 5-Fluorouracil, Oxaliplatin, Irinotecan, Cetuximab (also known as Erbitux) and Avastin ( also known as Bevacizumab).This new drug has two active components, trifluridine and tipiracil. Trifluridine is a new nucleoside analog. In other words, a nucleoside is a nitrogen containing biologic compound linked to a sugar, which when phosphorylated, turns into a nucleotide, which is a vital part of the DNA backbone. Trifluridine therefore is a nucleoside analog, meaning it isn't but acts like a nucleoside. It incorporates itself into the DNA structure and interferes with cell growth and proliferation. Tipiracil inhibits the enzyme thymidine phosphorylase, which catalyzes the degradation of Trifluridine, thus allowing it to last longer. Thymidine phosphorylase by itself has pro-angiogenic properties, meaning it promotes blood vessel formation and encourages better blood supply of tumors, so Tipiracil directly stops this advantage. Furthermore, Tipiracil by stopping thymidine phosphorylase, prevents the formation of thymine and 2-deoxy-alpha-D-ribose 1-phosphate. 2DARP is a strong reducing sugar product of thymidine catabolism and causes increased oxidative stress within tumors, promotes release of more tumor blood vessel promoting factors ( angiogenic growth factors) such as interleukin-8, vascular endothelial growth factors VEGF, and matrix metalloproteinase-1 an enzyme which breaks down collagen and extracelular matrix, which is key in promoting tumor metastases. This three mode action of tipiracil ( inhibits thymine production, thymidine phosphorylase VEGF activity, stops ROS and MMP-1 , VEGF and cytokine production)- makes it more attractive since it can potentiate the action of the common colorectal chemotherapy drug 5- fluorouracil whose main action is to inhibit formation of thymine. The RECOURSE trial, a —international, randomized, double-blind, placebo-controlled study conducted in patients with previously treated metastatic colorectal cancer apparently resulted in statistically significant improvement in overall survival and progression free survival . The drug is given orally, twice a day, for two straight weeks, minus weekends, followed by a two week break. Side effects are listed as anemia, neutropenia, asthenia/fatigue, nausea, —thrombocytopenia, decreased appetite, diarrhea,vomiting, abdominal pain,—pyrexia. Since it is barely a month since FDA approval ( Sept. 24, 2015) it still has not hit our pharmacy shelves. I am however eager to try this. Will update you again in a few months. 

Getting into ketosis

March 25, 2022
How long does it take to get into a state of clinical ketosis? By ketosis, I mean the levels of beta-hydroxybutyric acid reaching to above normal levels yet not high enough to bring you into a medical emergency such as ketoacidosis. As little as a day is all it takes. You an achieve this in different ways. The most common and sure fire method is to simply stop eating. If you fast and only limit your intake to water or sugarless herbal , which technically has ZERO calories, you will achieve a state of ketosis in no time. Another way is to try fasting for 15 hours a day, or roughly, just eat one full meal daily. this should bring you into ketosis too, though not all 24 hours are involved. If you try a ketogenic diet, that means, you will be limiting your carbohydrate intake to approximately 20% of your total daily intake, and take the rest in the form of fats ( 70-75%) and proteins (5 to 10%).  Monitoring your progress will be helpful. A simple glucometer will suffice. Individual serum Ketone sticks, readily available from Amazon.com or special order through your pharmacy can be used to check your ketone levels throughout the week.

Update on clinical trials of the ketogenic diet in cancer

March 25, 2022
Several clinical trials are ongoing throughout the United States at the moment.  The University of Iowa Department of Radiation Oncology is running a couple of Phase I trials on the use of the ketogenic diet plus radiation and chemotherapy in head and neck cancers, and they also have another which studies the ketogenic diet plus chemoradiation in non-small cell lung cancers and pancreatic cancer. Michigan State University has one which recruited brain cancers, also known as glioblastomas, a very deadly type of brain cancer. Duke University recently began a randomized trial studying the ketogenic diet plus androgen deprivation therapy in prostate cancer , using the ketogenic diet versus a control standard diet. Unfortunately per recent info posted on the clinicaltrials.gov website, the trial was terminated as of December 2015, due to lack of funding, and due to the principal investigator leaving . Closer to home, the Veterans Affairs Medical Center in Pittsburgh has their own trial which recently concluded in 2015. This trial recruited patients with advanced solid tumors across broad tumor types and patients dieted up to 16 weeks or until tolerated. The results have not yet been publicly released as it is currently under manuscript review.
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