Abstract: Inflammation is now said to be the cause of not only heart disease but also almost all chronic diseases such as cancer, diabetes, osteoporosis, Alzheimer’s, arthritis, asthma, aging, obesity, etc. The symptoms manifested by inflammation include swelling, tender joints, sore throat, rash, runny nose, blisters, bleeding gums, depression, lethargy, fatigue, etc.
Chris K. H. Teo
CA Care, 5 Lebuhraya Gelugor, 11600 Penang, Malaysia.
According to Time magazine one of the top 10 medical breakthroughs in 2008 is the study that confirms inflammation is just as important as cholesterol when it comes to preventing heart disease. Most of us know about cholesterol because that is what we have been told all along but inflammation? It is something not commonly heard of or talked about. But you will surely know about it when someone can find a way to put a better anti-inflammation drug in capsules!
Inflammation is now said to be the cause of not only heart disease but also almost all chronic diseases such as cancer, diabetes, osteoporosis, Alzheimer’s, arthritis, asthma, aging, obesity, etc. The symptoms manifested by inflammation include swelling, tender joints, sore throat, rash, runny nose, blisters, bleeding gums, depression, lethargy, fatigue, etc.
Inflammation is derived from Latin, meaning to set on fire. It is the body’s response to acute tissue damage due to infection by bacteria, viruses, fungi, chemical irritation and /or physical injury. It is a natural bodily function of protecting and keeping us alive. Without inflammation wounds or infection would not heal and this may eventually kill us.
Inflammation is characterised by the tissue turning red, warm and swollen accompanied by varying degrees of pain. This is what happens after an insect bite or the body is injured. Since this process is so important to survival, it is well worth knowing in a little more detail what happens when a part of our body is inflamed. The scientists equate inflammation as the alarm system. When the body is under attack the inflammatory process is triggered and the following happen:
a) The blood vessels dilate allowing more blood to flow to the danger or inflamed zone. As a result of increased blood flow, the tissue appears red and warm. Increased blood flow also means dispatching of numerous soldiers or immune cells to the danger zone. At the same time, there are also more blood sugar and oxygen supplied to the inflamed tissue.
b) The blood vessels in the inflamed area become leaky and fluid leaks out from the bloodstream into the body tissue. This fluid contains the soldiers or antibodies and repair materials in the form of clotting factors etc. that help seal off the wound thus containing the infection. The leakage of fluid into the tissue makes it swell and as a result may also cause pain.
c) The danger zone is now turned into a war zone. The immune cells of the body surround theenemies and eat them up. When the battle is won, what is left is a fluid which can be thin and watery (as seen in blisters) or thick and white which we recognize as pus. It is important to note that the war is carried out by a variety of soldiers and each of them carries out a specific job. In order to co-ordinate the activities of these soldiers the body produces different messenger molecules. Indeed this is a well coordinated, complex and sophisticated war.
d) After the war is won, the immune cells start to repair the damage. We begin to see the healing as new cells are stimulated to grow and the damaged tissue restored to what it was. This growth of new tissue and blood vessels involves different cells and different chemical messengers. When this is done, inflammation process stop – the threat has been neutralized, damage repaired and the body returned to health.
Carcinogenesis – The Creation of Cancer
Molecular biologists tell us it is not easy for cells to turn cancerous. Also it takes many years, probably decades, before cancer creates enough symptoms to make life difficult for its victim.
Carcinogenesis or the creation of cancer is generally recognized as a multi-step process with the following distinct stages:
- Tumour initiation: this is a rapid process and may take 1 or 2 days. Something happenedcausing damage to the genetic material (such as DNA) in the cell. Actually many things must happen. A single event does not change a good cell to a bad cell. The cell has the capacity to repair DNA damage. But if for some reason this repair mechanism is switched off then mutation is allowed to proceed resulting in a mutated cell. This mutation is an irreversible process.
- Tumour promotion: this stage is relatively lengthy. It could probably take more or less 10 years. It represents a phase where the cell begins to multiply and become a population of malignant cells. It is said that the inflammation process represents the match or trigger that starts the cancer fire. Fortunately for cancer patients, this promotion stage can be reversed by appropriate stimuli (e.g. food).
- Tumour progression: this involves the growth of a tumour which not only grows and multiplies but also has the potential to spread to other parts of the body. This process may take a year or so.
From Chronic Inflammation to Cancer: How does it happen?
Chronic inflammation: The sages of India and China often tell us that in all good, there is also a bad; and in all bad there is also a good. While inflammation is life-saving and is essential for our survival, it is a double-edged sword. Inflammation should only be transitory and not last too long. Short-term or acute inflammation heals wound and protect us from diseases but prolonged or chronic inflammation can turn against us by using the same life-saving mechanisms to cause good cells to mutate, multiply, grow and spread as in cancer.
It is now recognized that chronic inflammation is the engine that drives today’s many chronic diseases. It has been linked to the development of cancer. The longer chronic inflammation persists the higher the risk of getting cancer. In fact, cancer is now described as the wound that does not heal.
It is important to know that even if mutation has occurred, it does not mean that you will get cancer. It is just that you are prone or have a higher risk of getting cancer. The precancerous mutated cell may remain dormant and harmless in you for years until such time when a trigger or stimulus comes along to push this mutated cell towards malignancy. In fact what you do to yourself after the tumour initiation stage can determine whether you get cancer or otherwise.
The following need to happen for a tumour to proceed towards malignancy:
1) The mutated cells need to multiply and grow.
2) The new population of cells must be able to support itself by creating its own blood supply.
3) It must also be able to become insensitive to the normal cellular control mechanisms, hence behaving like a rebel with the capacity of unlimited growth.
4) The tumour cells must break away and be able to invade and thrive in other tissues of the body.
The above processes are complex but are well orchestrated involving a delicate, yin-yang balance. To illustrate the complexity of what can happen, let us examine the yin-yang roles of the macrophage. Macrophage (meaning big eater) starts out as the white blood cell which we call monocyte. Monocytes that leave the blood stream turn into macrophages. Macrophages are specialized immune cells that eat up bacteria, viruses and dead or injured body cells. In addition, macrophages play an important role of alerting the rest of the immune system of invaders.
Macrophage Can Cause Damage to the DNA
During inflammation macrophages fight the infection by generating free radicals or reactive oxidative species (ROS) such as the highly reactive oxygen and nitrogen species. Free radicals are weapons of enemy destruction and are therefore beneficial but only for the short-term. Prolonged presence of ROS (as in chronic situation) is harmful. These ROS can react with the DNA to cause mutation. For example the bioreactive nitric oxide (NO) not only causes DNA damage but also promote cancer progression by helping the tumour create its own blood vessels. Many of us know the need for anti-oxidants to counter this effect. Antioxidants react with the ROS to prevent DNA damage and mutation.
In addition to free radicals, macrophages and T-cells of the white blood cells may release Tumor Necrosis Factor alpha (TNF-apha) and macrophage Migration Inhibitory Factor (MIF). These two factors further help the DNA damage.
MIF has now been shown to have many functions related to cancer creation. One of its key roles is to turn off the tumor repair mechanism of p53. By turning off this switch, it helps cells with DNA damage to accumulate.
In oesophageal cancer, MIF has been shown to enhance the production of Vascular Endothelial Growth Factor (VEGF) and interleukin-8. These promote the formation of blood vessels (angiogenesis) and tumour growth.
Tumour-Associated Macrophage (TAM)
It is now known that a tumour does not consist entirely of cancerous cells, rather it comprises a range of non-cancer cells as well. A major component of this so called tumour is macrophages. At first it was thought that macrophages were there to act as the body’s defense mechanism. It turns out to be the other way round – these Tumour-Associated Macrophages (TAMs) are actually collaborating with the tumour cells. High levels of TAMs found in malignant tumours of breast, prostate, uterine cervical, liver, lung, bladder, kidney, brain, etc., indicate poor prognosis.
It is also shown that the macrophages have switched their role from protecting us to helping the tumour cells by producing a factor called Interluekin 8 (IL-8). IL-8 helps tumour to create its own blood vessels.
It is also known that TAMs can release a vast diversity of growth factors, enzymes, cytokins, etc. Many of these factors play key roles in metastasis (spread of cancer). TAMs promote metastasis through many ways, such as induction of tumour growth and enhancement of ability of tumour cell to migrate and invade tissues.
Cancer cells cannot grow all by themselves. They need to be implanted onto a bed of normal cells called stroma. The stroma provides support and nourishment to the cancer cells. The stroma comprises not only the malignant cells but also extracellular matrix (ECM) and many other non-malignant cells types such as fibroblast, endothelial cells and various immune cells like macrophages, neutrophils, mast cells and lymphocytes.
The stroma cannot support tumour growth indefinitely. After attaining the size of about 1 or 2 mm the tumour must learn to support itself by forming its own blood vessels to nourish itself. If it is unable to do so the tumour may just wither and die. Unfortunately for us, cancer cells are able to stimulate the formation of new blood vessels through angiogenesis. A tumour with its network of blood vessels will be able to grow and flourish like a parasite in our body.
A report of The Think Tank of the National Cancer Institute, Division of Cancer Biology stated:
- The microenvironment or stroma in which a tumour originates plays a critical role in tumour initiation and progression.
- This cancer cell is absolutely dependent on the stroma for its proliferation, progression and metastasis.
- The tumour microenvironment influences the growth of the tumour and its ability to progress and metastasis.
- Manipulating host-tumour interactions may be important in preventing or reverting malignant conversion, and re-establishing normal control mechanism.
It is most encouraging to note that science has at long last recognized the unique interrelationship between the cancer cells and its microenvironment. The debate about the seed and the soil has dragged on since the days of Pasteur’s germ theory. The practitioners of alternative medicine have all along championed the concept that the soil or microenvironment is an important factor. The seedmay be viable but if the soil is not conducive further germination and growth would not succeed. Modern medicine had completely ignored this concept believing that its drugs can fix everything that has gone wrong regardless of the microenvironment.
The idea that we can manipulate the cell’s microenvironment to prevent or reverse malignant growth requires us to re-look and critically re-examine the current ideas and practices of cancer therapy. This is indeed exciting because we can now do something for ourselves to help prevent and reverse the cancer in us.
Promoters and Anti-promoters of Cancer
Professor Colin Campbell of Cornell University had devoted many decades of experimentation on the role of nutritional factors in cancer. And this is what he concluded:
- The promotion stage in cancer is reversible, depending on whether the early cancer growth is given the right conditions in which to grow. This is where dietary factors are so important.
- These dietary factors, called promoters, feed cancer growth.
- Other dietary factors, called anti-promoters, slow cancer growth.
- Cancer flourishes when there are more promoters than anti-promoters.
- Cancer growth slows or stops when the anti-promoters prevail.
What Dr. Campbell wrote is clearly in total contradiction to what most doctors today tell their cancer patients about food – You can eat anything you like. Cancer has nothing to do with what you eat. Such medical advice is never based on research and at best reflects ignorance, arrogance or personal bias.
This is what I would say to cancer patients and all those involved in caring for cancer patients – if you have the chance to read only one book in this world, and if you wish to know how to help yourself and others, then the book that you need to read is Dr. Campbell’s book – The China Study. After reading this book you will know the truth.
And to cancer patients I say this: this truth will empower you and make your free, and to cancer care givers I wish to remind you: this truth will make you convey the right messages to cancer patients.
It is about time that we stop killing cancer patients through wrong advice, particularly about food. For we now know that if the tumour’s microenvironment is deprived of the inflammatory factors, the tumour may fail to grow and spread. These inflammatory factors are fertilizers for cancer and they are provided directly through the food we eat. So we can influence the cancer microenvironment through changes in our diet and lifestyle.
Dr. Russell Blaylock, neurosurgeon and researcher on nutrition wrote (The Blaylock Wellness Report,June 2008):
- The typical Western diet, high in omega-6-fatty acids, sugar, refined carbohydrates and low in fruits and vegetables strongly promote inflammation.
- Artificial sweetener is a brain toxin and promotes cancer.
- Fluoride (in toothpaste, mouthwash, dental treatment) when combined with aluminum results in brain inflammation.
- Diet high in red meat has high iron content. Iron acts as a catalyst for free-radical production and this increases inflammation.
- The most powerful anti-inflammatory foods include cruciferous vegetables – cauliflower, Brussels sprouts, broccoli, kale, kalian, sawi, etc. – fruits and omega-3 oils.
Dr. Richard Beliveau is a researcher in biochemistry and professor at the University of Montreal, Canada. It is said that when Richard Beliveau got to talk about Western diets, he was distressed. This is what he said: With all I’ve learned over these years of research, if I were asked to design a diet today that promoted the development of cancer to the maximum, I couldn’t improve on our present diet!
Dr. Russell Blaylock, in his book, Health and nutrition secrets, wrote: It is a crime that medicine has all but ignored nutrition – one of the greatest weapons we have against disease.
Dr. Dan Chesnut practiced medicine for 44 years and he wrote in his book: Lying with authority:
- What could be done to change a very sick medical profession which just would not listen?
- I researched the literature and I listened to thousands of patients doing “different” things, especially with food and supplements. Like me, you have been subjected to years of misinformation and distorted facts about the causes and treatment of disease and about food.
- You who are sick, you who are in the health care professions, have only to …learn the truth. Facts: 80% to 90% of diseases in the top 10 causes of death could be prevented and helped by nutritional and life style changes.
Reversing Prostate Cancer By A Change of Diet and Lifestyle
Dr. Dean Ornish is Professor of Medicine at the University of California at San Francisco and founder and president of the Preventive Medicine Research Institute. He has spent more than 30 years studying the effect of exercise, diet and stress on health. Dr. Ornish was the first to show that lifestyle changes could actually reverse severe heart diseases without medication or surgery. Following this breakthrough, he published yet another paper in the Journal of Urology (174:1065-1070 – September 2005) showing that the progression of early-stage prostate cancer may be slowed, stopped or perhaps even reversed by following the recommended diet and lifestyle changes. This is the first randomized control trial showing that the progression of any type of cancer may be modified just by changing what we eat and how we live.
On 16 June 2008, Dr. Ornish presented a testimony to the US Congress. He said:
- Our research has shown that your body has a remarkable capacity to begin healing itself … if we address the lifestyle factors that often cause these chronic diseases.
- Many people tend to think that breakthroughs in medicine as a new drug, laser or high-tech surgical procedure. They often have a hard time believing that the simple choices that we make in our lifestyle – what we eat, how we respond to stress … how much exercise we get and the quality of our relationships and social support – can be as powerful as drugs and surgery. Often, even better.
- Lifestyle changes … are free rather than by taking a lifetime of drugs that are costly.
The Anti-cancer Diet, Lifestyle and Environment
Dr. David Servan-Schreiber is both a MD and a Ph.D. (now clinical professor of psychiatry at the University of Pittsburgh School of Medicine, USA) and while in his early thirties, described himself as:Quite sure of success, confident in hard science, a little arrogant, I have to admit. He and his colleague were the rising stars of American psychiatry. We had mastered the latest technology no one was using yet. One day in his own laboratory, he saw a round ball, the size of a walnut in his brain. It was brain cancer. He wrote: I received conventional treatment and the cancer went into remission, but I relapsed after that.
After surgery and chemotherapy, I asked my oncologist … what should I do to lead a healthy life and what precautions could I take to avoid a relapse? “There is nothing in particular to do. Live your life normally. Do what you like. It can’t do you any harm. We’ll do CAT scans at regular intervals and if your tumour comes back, we’ll detect it early,’ replied this leading light of modern medicine.
When I went back to see my oncologist after the second operation that followed the relapse … I asked him if I ought to change my diet to … avoid another relapse. His answer is perfectly stereotypical: “Eat what you like. It won’t make much difference.”
It took me months of research to begin to understand how I could help my body protect itself from cancer. This is what I learned: each of us has a body designed to fight the process of tumour development. I changed from a scientist-researcher completely ignorant of the body’s natural defences to a physician who counts above all on these natural mechanisms – to use our body’s natural defences.
Dr. David Servan-Schreiber wrote a book, Anti-cancer, a new way of life. In this book he provided information on anti-cancer food and also how to live a life with an anticancer mind andanticancer body.
Ait Varki et al at the University of California, San Diego School of Medicine reported that eating red meat and milk products cause inflammation due to the presence of a type of glycan called N-glycolylneuraminic acid (Neu5Gc) found in these products. He said:
- Chronic inflammation results from interaction of Neu5Gc accumulated in our bodies from eating red meat with the antibodies that circulate as an immune response to this non-human molecule and this may contribute to cancer risk.
Chemotherapy and Radiotherapy Cause Inflammation
Paul Mills et al (in Brain, Behaviour and Immunity, 22: 98-104, 2008) reported that chemotherapy treatment for breast cancer resulted in increased inflammation. In another paper (Biological Psychology 69: 85-96, April 2005) Paul Mills et al. reported that increased fatigue, poor mood and reduced quality of life after anthracycline-based chemotherapy was the result of increased inflammation.
Amir Abushamaa et al. (Am. J Physiol Lung Cell Mol Physiol 283:L336-L345, 2002) reported that high-dose chemotherapy in breast cancer treatment resulted in oxidative stress and inflammation and these were manifested as lung toxicity.
RG van der Most et al (Cell Death and Differentiation 15: 13-20, 2008) reported that chemotherapy caused cell death resulting in high levels of pro-inflammatory uric acid from the dying cells and this was not associated with curative responses but rather resulted in chronic inflammation.
Karan Bhalla, et al. (Am J Respiratory and Critical Care Medicine 161:17-25, 2000) reported that the CAF (cyclophosphamide, doxorubicin and 5-FU) chemotherapy caused adverse lung function and also induced inflammatory cellular response. Cyclophosphamide probably caused oxidative damage by increasing the generation of reactive oxygen species and depleting glutathione store.
Radiating the chest or breast can causes inflammation of the lungs. Doctors call this pneumonitisand if this condition persists can lead to the irreversible and permanent scarring of the lungs. This condition is called radiation fibrosis that typically occurs a year after the completion of treatment. (Note: the medical term ending with itis refers to inflammatory condition).
Radiation enteritis is another significant problem in patients receiving radiation treatment to the pelvis or abdomen. This is because the large and small intestines are very sensitive to radiation. All patients undergoing radiation to the abdomen, pelvis or rectum will show signs of acute enteritis.Chronic enteritis may appear months to years after the treatment is completed.
Inflammation is manifested many ways. For example, if the bladder is irradiated you may experience urinary frequency. On the other hand, irradiation of the lungs can cause dry cough – another manifestation of inflammation.
Meritxell Molla and Julian Panes of Spain (World J Gastroenterology 13:3043-3046, 2007) wrote:
- Treatment of malignant tumours by radiotherapy is limited by the need to avoid acute and late damage to healthy tissue.
- Radiation induces an important inflammatory response in the irradiated organs, characterized by leukocyte infiltration and vascular changes that are the main limiting factor in the application of this therapeutic modality for the treatment of cancer.
Dennis Hallahan and S. Virudachalam (Proc Natl Acad Sci USA 94:6432-6437) showed that tumour necrosis factor alpha (TNF-alpha) is induced after irradiation of tumour cells. As explained earlier TNF-alpha can have various undesirable effects.
Nancy Baxter et al (Gastroenterology 128:819-824) wrote:
- Radiation therapy for prostate cancer has been associated with an increased rate of pelvic malignancies, particularly bladder cancer.
- We noted a significant increase in development of rectal cancer after radiation for prostate cancer.
Peter Kash and Jay Lombard in Freedom from disease, wrote:
- Chemotherapy … is already being viewed less as a cure and more as a means of gaining time.
- With chemotherapy, both the cancer and the immune system are weakened, but the cancer is able to rebound more rapidly, in part because … chemotherapy leaves in its wake enormous quantities of free radicals, which can trigger additional mutations in DNA and bring about the rebirth of the disease.
Ask Yourself These Questions
- When you are diagnosed with cancer, the next thing you are told is: Must operate immediately. Don’t wait. Otherwise the cancer will spread. At the time you are told you have cancer, cancer biologists tell us cancer is already in your body for the past 10 years. Why are you not given a bit of time to think things over? What’s the hurry? Is creating an atmosphere of fear and panic justified?
- Cancer cells cannot live by themselves. They need to be nourished. The food that we eat is also the food that feed the cancer cells. Medical science is beginning to acknowledge that the microenvironment surrounding the cells can determine whether the cancer cells can progress into full blown malignant tumour or just shrink and die. Certain foods promote growth of cancer cells and certain foods inhibit their growth. It is like the seed in the garden – certain fertilizer promotes growth of leaves, certain fertilizer promotes growth of roots or fruits. Is this reasoning not logical enough? Why are you told that you can eat anything you like and that food has nothing to do with cancer? This is saying that cancer cells can grow by themselves independent of their surrounding. This is a direct contradiction of current knowledge of cancer biology.
- Cells in our body die everyday through apoptosis. Such cell death is a natural process and it does no harm to the body. But cell death due to chemo-drug is different. It initiates the process of chronic inflammation. What can you learn from this? Cells die. Natural death is safe but poisoned-death is harmful. In science, little or shallow knowledge is dangerous!
- Chemo-drug and radiation generate free radicals in the body. Free radicals can destroy the DNA of both the cancer cells and healthy cells. What happen when the DNA of healthy cells are made to mutate? Will that not plant the seed for more or other cancers down the road?
- Radiation causes inflammation. Adding poisonous chemo-drug into your body causes inflammation. Chronic inflammation causes cancer. Does this not mean chemotherapy and radiation by themselves can also cause cancer?
It doesn‘t matter what disease you are talking about, whether you are talking about a common cold or cardiovascular disease, osteoporosis or cancer, the root is always going to be at the molecular and cellular level. The root is known in many other areas of science, but the problem is that medicine really isn’t a science; it is a business ~ Ron Rosedale, M.D.
Explanation of some technical terms
What is Tumour Necrosis Factor-alpha (TNF-alpha)?
TNF-alpha affects body organs in different ways. On the hypothalamus (part of the brain) it suppresses appetite and causes fevers. On the liver and other tissues, TNF-alpha induces insulin resistance. On the macrophages, it stimulates phagocytosis (engulfing and ingestion of bacteria or other foreign bodies by the macrophages) and also causes blood clotting which serves to contain the infection. In summary, TNF-alpha can be either growth stimulating or growth inhibiting. It can cause death of certain tumour cells while at the same time promotes growth in some other types of tumour cells. Prolonged overproduction of TNF-alpha may result in cachexia, a wasting syndrome commonly seen in cancer patients – characterized by loss of appetite, weight loss and anemia. TNF is implicated not only in cancer but also in other autoimmune disorders such as rheumatoid arthritis,spondylitis, Crohn’s disease, psoriasis and refractory asthma.
What is p53?
P53 is often referred to as the guardian angel gene or master watchman. Its primary role is to prevent genetic mutation in the cell by the following actions:
a) It repairs the DNA damage.
b) It temporarily stops cell cycle long enough so that the DNA repair proteins will have time to fix the damage before the cell will be allowed to continue the cell cycle.
c) If the DNA damage cannot be repaired, p53 can initiate apoptosis.
What is Apoptosis?
Apoptosis is a natural, programmed suicidal death of a damaged cell. When a cell becomes mutated and does not repair itself, the cell has a natural method of preventing that mutation from being passed on to the next generation of cells. These mutated cells are induced to commit suicide. If apoptosis is inhibited or switched off, carcinogenesis proceeds
What is Angiogenesis
No living cells can survive if they are not in contact with tiny blood capillaries which nourish them with oxygen and nutrients. Also waste from the cellular metabolism must be carried away from them. Therefore, to survive a tumour needs to be deeply infiltrated with capillaries. A tumour can never grow bigger than the pin head without these capillaries. Dr. Judah Folkman put forward these key concepts about cancer:
- Micro tumours cannot change into dangerous cancers without creating a new network of blood vessels to feed them.
- To do so they produce a chemical substance called angiogenin.
- Large primary tumours send out metastasis. But as in any colonial empire, they prevent these distant territories from becoming too large by producing another chemical called angiostatinto block the growth of new blood vessels.
- This explains why metastases can suddenly grow once the principal tumour has been surgically removed.
The control of angiogenesis is a central concern in the treatment of cancer. Specific dietary practices and reduction of inflammation have powerful effects on angiogenesis.