Report on the 4th Annual NOAT Congress: Advances in Nutritional Oncology: From Carcinogenesis to Therapeutic Intervention November 5-7th, 1998 Prior to 1997 this organization and the dietitians and nutritionists who make up the bulk of the membership (which includes some oncologists as well as many researchers), discuss nutrition in terms of cachexia solely. Cachexia is the wasting away that many cancer patients experience at the end stages of their disease. Nutrition now has come to mean advising patients and indeed people who are well, on all aspects of diet, food choices and supplements. This is a tremendous advance for the public and patients. The goal of this particular conference was to help the members understand how to assess botanical products, phytochemicals, "neutraceuticals and pharmaceuticals with nutritional implications for the oncology patient". The concern is for supportive nutrition as well as adjuvant (used to decrease therapeutic toxicity and possibly improve outcome). It is very likely that interest in this area has been patient-driven. It is a direction for all of us to encourage. Daniel Nixon, MD and NOAT President spoke about his research in ellagic acid(especially found in raspberries and strawberries). This was reported on last year as well. This year they gave healthy people a raspberry puree to see if it had an effect as chemoprevention. In cell lines (for colon cancer), ellagic acid was shown to arrest growth and help cells die (apoptosis). The value of fiber, both soluble and insoluble was stressed. The following beneficial factors have been identified: 1)It binds tumorgenic (cancer-causing) compounds 2)It modifies inhibitors 3)It dilutes bile acids 4) It shortens transit time for waste products Steven K. Clinton, MD PhD, the director of the Center for Nutrition and Chemoprevention at Ohio State University spoke about tumor angiogenesis (development of blood vessels that feed tumors) and nutrition. It has been shown that diet (nutrition and phytochemicals) can influence tumor angiogenesis. Soy protein in particular has shown an effect (in rats and mice) in inducing apoptosis and limiting proliferation of cells. The studies that are often referred to in order to disprove the value of beta carotene also demonstrated a reduction in the amount of prostate cancer that developed as well as substantial decrease in the incidence of mortality. Winfred F. Malone, from the Chemoprevention branch of NCI told us that there are currently 40 human efficacy trials using natural substances. He pointed out that the studies are now including single agent randomization AND combinations of agents and complete factorial designs. The work is using populations of healthy people as well as high risk, those with pre-neoplastic conditions as well as previously treated cancer patients. Most studies use intermediate markers (not death) because it enables them to study a smaller group and get usable results. A short discussion of the Finnish beta-carotene/vitamin E male smokers’ study ensued. The beta-carotene arm may have caused lung cancer to potentiate but the vitamin E was shown to reduce both incidence of prostate cancer (32%) and mortality from prostate cancer (41%). These are important findings. In contrast a talk was given by Joel L. Schwartz, DMD, DMSc on the use of retinoids and carotenoids working with lung and head and neck cancers. Twenty-five years ago, studies were conducted by Michael Sporn using retinoids with lung cancer. There was some success but the side effects were difficult. Today’s retinoids have resolved some of those problems. Dr. Hong of M.D. Anderson has been able to show "a significant reduction in second primary cancer of the head and neck and a reversal of premalignant oral leukoplakia" (New England Journal of Medicine). Studies in Dr. Schwartz’s laboratory working with vitamin E, beta carotene, vitamin C, glutathione or a combination showed that the best method to reduce oral carcinogenesis was using a mixture of all supplements. Next best was beta carotene, then glutathione, then vitamin E alone, then vitamin C alone. The timing of such treatments may be important (if only we knew what it was). Paul Talalay, MD the creator of broccoli sprouts spoke about the research at his labs. The broccoli samples that his staff bought at local food stores varied tremendously as to the levels of sulforaphane. I did not get the opportunity to ask if any of the broccoli was organic. Studies at Rutgers agricultural college have shown a vast difference in vitamin and mineral content with organic versus non-organic (grown with use of pesticides). Extracts of broccoli sprouts were shown to block mammary carcinogenesis (Fahey,JW, Zhang, Y, Talalay, P,(1997) Proc. Natl Acad. Sci USA 94, 10367-10372) Dr. Talalay’s conclusion: "prospecting edible plants for chemoprotective enzyme inducer activity is an important and fruitful objective." "(the) addition of such plants or their extracts will lead to the reduction of the risk of developing malignancy, and is an important, compelling, and realistic goal." Kenneth CH Fearon, University of Edinburgh, Royal Infirmary has been doing research with omega 3 fatty acids(EPA) and their ability to reduce cytokine production in healthy patients. Proinflammatory cytokines regulate host immune and somatic tissues. Disfunction can lead to shock, tissue injury, anorexia, malnutrition and cachexia. Patients with advanced cancer were given EPA (eicosapentaenoic acid) along with nutritional supplementation and they experienced a weight gain. Since the nutritional supplementation (600K cal plus 30g protein) sometimes resulted in weight stabilization, this was good news. Julie Harms, RD, LD, CNSD from MD Anderson Cancer Center in Orlando, FL spoke about nutrition and herbals for the immune system. She is involved with oncologic nutrition. Attached is a one page summary of the products she discussed. A one page abstract from Edward M. Croom, Jr, PhD is also included. For the second time this month I heard a presentation from David Kritchevsky, PhD on conjugated linoleic acid(CLA). This is "present in dairy products and meats from ruminant animals" (grass eaters/grazers). It has been shown "to inhibit growth of skin and gastric and mammary tumors in mice. The mechanism of action is unclear. CLA is found in yogurt but not non-fat. Dr. Kritchevsky stresses the difference between linoleic acid and CLA and is clear that we don’t know where this research will lead. Animal studies have shown that saturated fat is less promoting (of tumors) than unsaturated fat. Fish oils (see above) are less promoting as well. They are polyunsaturated but low in linoleic acid. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.