The Doctor’s channel

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 Breast Cancer risk after Supradiaphragmatic Radiotherapy (SR) persists beyond 40 years  Low Total Cholesterol does not lead to cancer
 (interview with William Fredette, MD)

Woman who received radiotherapy above the diaphragm for Hodgkin’s Lymphoma (HL), have an increased risk of breast cancer that persists up to 40 years post-therapy (J. Clin. Oncol.). 5002 woman under age 36 with HL who received SR from 1956-2003 were followed through the end of 2008.  373 of these woman developed breast cancer or ductal carcinoma (in situ) during  follow up. The Standardized incidence ratio (SIR), was greatest for patients treated at age 14 and remained high for at least 40 years. This group had a maximum absolute excess risk at ages 50-59. The cumulative risk of breast cancer for those woman who were treated at the ages between 20-24 , at 20 years post SR was 3.5%, and at 40 years post SR was 29.2%.  The cumulative risk of breast cancer for those woman treated with SR and Alkylating Chemotherapy and/or Pelvic Radiotherapy between ages 20-24 at 20 years post-treatment was 3.6%, and at 40 years post-treatment was 11.5%.  According to Dr. Anthony J. Swerdlow and Colleagues from the Institute of Cancer Research, Sutton, Surrey, England, these large cumulative risks in woman treated with SR suggest that “intensive breast screening programs for such woman may need to continue for 40 years or longer after initial radiotherapy”.

 (interview with Mary Leuchars, MD)

Earlier studies have shown that low total cholesterol (TC) levels were associated with cancer risk. New studies challenge these which show that low TC is not a cause of cancer. The link between low cholesterol and cancer risk disappeared when it was shown (via proper “exclusion data”), that low TC levels were the result of an underlying cancer and not the cause itself. In one study with long-term smokers, it was shown that higher levels of HDL cholesterol were associated with a 14% decrease risk of cancer. Another study following 5,586 males older than 55 years of age showed that these men with a TC below 200 had a 59% reduced risk of high-grade prostate cancer (PC),(Gleason score 8-10). In these men there was no association seen for PC or for PC with a lower Gleason score. Also noted was that prophylactic statin drug therapy in men presenting a normal lipid profile offered no anticancer advantage. Thus, the “lipid-cancer link” challenge appears to be quite valid in that it is evident that additional research is required in order to obtain more conclusive evidence of any true link between lipid levels and cancer risk and/or occurrence.
 Liver Protection from Toxins & Harmful Metabolites Breast Cancer Video Gives Patients Visual Breakdown of Condition

 (Interview with Robert Berger, MS, MVSc, PhD)

A lot happens in the liver; substances are formed (synthesized), and are also broken down (catabolized). In addition, harmful metabolites are formed in the liver which can affect our overall health. Much of the time, many of these metabolites are more harmful and/or potentially dangerous than the original (primary) substances which are being converted. These dangerous metabolites have the potential to be stored and even get “stuck” in the body. The good news; there are natural substances that we can obtain from our foods, drugs, supplements, etc., that can eliminate these potentially dangerous metabolic substances by re-routing their metabolic pathways and allowing them to be converted into safe by-products and “benign” metabolites that usually have little potential to harm us. One natural substance that does this is Indole-3-Carbinol (I3C), an integral component of broccoli. I3C blocks specific enzyme pathways in the liver’s Cytochrome P450 system that can convert certain substances, drugs, and chemicals into dangerous and potential disease-initiating metabolites, many of which can pre-empt specific cancers, (i.e., breast and/or prostate cancer). I3C initiates the metabolic shift of these substances to a more benign pathway where even if these metabolites are stored, their potential for harm is attenuated at worst. This also allows for these substances to be excreted in the bile, urine, sweat, feces, etc., so they can do no damage. Another protective substance is L-Carnitine (L-CNE). Although L-CNE is not known as a “detoxifier” per se, because it is essential for transporting long-chain fatty acids (LCFAs) into the cell mitochondria for energy, it also stimulates the breakdown of fat (Lipolysis). When lipolysis occurs, fat-soluble toxins which are stored in fat are also released and are transported to the liver to be filtered out of the body. Because L-CNE is a fat mobilizer, it’s becoming more recognized as an effective detoxifier as well as an essential component for the β-oxidation of fats.

Breast Cancer (BC) is the second most frequent form of cancer in Europe with an estimated 245,000 new cases diagnosed each year. In woman it is the most common type of cancer. But it is not only specific for woman, as one in every 150 patients who are diagnosed with BC will be a man.  BC is also the second most common cause of cancer-related deaths in woman. However, with improved screening methods, extensive research, and the development of new treatments and advanced therapeutic procedures now being utilized, the outlook for patients has improved substantially in recent years.  The area of breast tissue that extends up into the armpit is called the auxiliary tail. From here, a network of vessels drain fluid (lymph), from the breast mainly into lymph nodes located in the armpit, but some is also drained into lymph glands behind the breast and collar bones. These lymph vessels belong to a network of channels and lymph nodes known as the lymphatic system which filters and returns lymph to the bloodstream and helps to protect the body against infection. Malignant tumors of the breast invade surrounding tissues and destroy them. Neoplastic (cancer) cells can also break off from the original tumor and travel through the lymphatic system and the blood stream to other organs where they anchor themselves and multiply (grow), to produce secondary tumors. This spread is called Metastasis. There are several forms of BC. The 2 most common forms of BC are Ductal Carcinoma (originally thought to originate in the milk ducts), and Lobular Carcinoma (originally thought to originate in the lobules). It is now known that both Ductal and Lobular cancers develop in the lobules and in the ducts, which drains the lobules…together known as the “Terminal Duct Lobular Unit”. These 2 types of cancer have a different behavior. If the cancer remains in its place of origin, either in the terminal duct or the lobule, it is described as in situ.
Being Overweight Appears Associated with Slightly Lower All Cause Mortality Relative to Normal Weight  (The Journal of the American Medical Association  (JAMA) Report)  Lifestyle Intervention in Diabetes: A Focus on Nutrition
The Body Mass Index (BMI) can provide important information on how much fat we carry in our body. Researchers compiled studies that carry the standard BMI categories of Normal Weight (BMI: 18.5-<25),  Over Weight (BMI: 25-<30), and Obesity. Obesity can be divided into three (3) classes: Class 1 (BMI: 30-<35), Class 2 (BMI: 35-<40), and Class 3 (BMI: 40>). These categories were developed by the World Health Organization (WHO) and the National Heart, Lung and Blood Institute. In a JAMA Report study, it was reported that obesity was associated with higher mortality relative to the normal weight category. Within these categories, the lower grade (Class 1) obesity was not associated with extra mortality relative to the normal weight category. Surprisingly, researchers also found that being overweight was associated with lower mortality relative to the normal weight category. In 80% of the 97 studies compiled for this research, it was shown that there was lower mortality in overweight than in normal weight people. These findings were consistent even though they involved people of all different ages and were in different parts of the world.  (interview with Zachary T. Bloomgarden, MD)

There are three basic components involved in lifestyle intervention when it comes to treating Type 2 diabetics (NIDDM). The first is screening for smoking and alcohol use/abuse. These are severe health risk factors for the diabetic. The second is exercise. Virtually everyone with diabetes should be able to do some exercise. Finally, there is diet. Most people claim to know what a “good” diet is…but in reality, most do not. Physicians are not generally the best nutrition experts either, especially when it comes to advising diabetics. Because of this, it is very appropriate for practicing physicians to identify nutritionists in their community, work with them, and to encourage their patients to see the nutritionist. When a physician sees the diabetic patient, there should be an interaction where the physician asks, “are you working on your diet?” “Do you need help?” This is a rational way of not asking physicians to spend a lot of time that they really don’t have, yet acknowledging that this is an integral part of treating their patient with diabetes.
 Obesity and Toxins  Late recurrence a risk for common childhood cancers
 (interview with Robert Berger, MS, MVSc, PhD)

When you have an obese individual, or a person that has a substantial buildup of toxins, estrogens, and xenoestrogens (foreign estrogens), the more fat one has in his or her body (especially visceral fat), the more of these potentially harmful substances are stored in this fat. Of course we want to lose this fat by burning it off as energy, but when we do, these substances are also released [from the fat] into the body. The release of these toxins can make things even worse as many of them may end up being re-stored in other fatty tissue or organs, such as in the breast. This is why it is of vital importance to keep our livers healthy and functioning in order to optimally convert these substances to their benign or less harmful metabolites and to aid in their removal from the body via the urine, feces, bile, sweat, etc. This also means that it is imperative to keep the kidneys functioning optimally as well. Woman who have a genetic family history of estrogen-driven cancers, such as with many breast, uterine, and cervical cancers, are at a significantly greater risk for these cancers, especially when these “toxins” are stored in their fatty tissues. Most notable here is breast cancer, which directly addresses the problem of why this type of cancer has become a virtual epidemic, as 83-87% of breast cancers diagnosed are estrogen-driven (ER+).

 (interview with Michael Banks, MD)

 Children who are cancer free for 5 years after being diagnosed are still at risk for recurrence up to 20 years or more post-diagnosis (J. Natl. Cancer Inst. (2009); 101:1709).  Data from the Childhood Cancer Survivor Study was collected which followed 12,795 survivors of the most common childhood cancers, i.e., leukemia, Hodgkin’s and Non-Hodgkin’s Lymphoma, neuroblastoma, soft tissue sarcoma, and tumors of the central nervous system, kidney, or bone. Subjects were diagnosed between 1970 and 1986. Investigators from Children’s Healthcare of Atlanta reported a 6% cumulative incidence of recurrence between 5 t0 20 years after the original diagnosis. The median age at diagnosis was 8.3 years, the median age was 26 years at follow-up, and the median follow-up was 21 years (maximum 34 years), from the initial diagnosis.  From the original 12,795 survivors, late recurrence developed in 806 of the patients, primarily between 5 and 10 years post-diagnosis. Cumulative incidences of recurrent disease at 10, 15, and 20 years were 4.4%, 5.6%, and 6.2%, respectively. The investigators note; “For most pediatric cancers, relapse after 15 years of recurrence-free survival is rare”. “Five-year disease-free survival is often interpreted to mean ‘cure'”…but… “There remain survivors among all diagnoses at risk for late recurrence. It is likely impossible to say when an individual survivor is ‘cured’ “. “By understanding the diagnosis-specific risks, patients, families, and their medical providers can be better informed of the probability of cure”.
 Vitamin D may decrease risk of Falls  Bisphenol A-BPA endocrine disruption
 (interview with William Fredette, MD)

According to a study in the Journal of Clinical Endocrinology & Metabolism, Vitamin D, especially in combination with calcium, may reduce the risks of falls. In a Meta-Analysis of 26 moderate studies using 45,782 subjects, (average age of 76 years old, with a median duration of D Supplementation for 12 months), D supplementation was associated with a significant 14% reduction in the risk of suffering at least 1 fall, and a significant 21% reduction in the number of falls.  These results were analyzed by subgroup analysis based on a patient’s dwelling, the route of D administration, adherence in the intervention group, and whether the study documented the increase in serum D levels in the intervention group. Other subgroup analyses suggested that fall reduction was greater among D-deficient patients, and when calcium was co-administered in both D supplementation and placebos. The studies suggest that when comparing D alone to placebo alone, the reduction in fall risk was minimal, but in studies comparing D plus calcium to placebo or calcium alone, the risk reduction in falls was significant. From these studies the authors conclude that “Uncertainty remains about the magnitude, but ‘most likely there is a benefit’ for Vitamin D supplementation. The appropriate supplementation dose and duration, as well as the target population for this intervention are yet to be fully defined.”  The authors also state, that the “Elderly who are likely to benefit the most from Vitamin D + calcium fall into 2 categories: those at high risk of falls, and those at risk of having Vitamin D deficiency.”

 (interview with Hugh S. Taylor, MD)

Hormone disruption is a considerable concern today. Environmental agents, many of which are toxic, have a high potential to invade our bodies and affect our overall health in negative ways. These agents may truly interfere with normal hormone action. One of the classic examples  is the plastic-based hormone disruptor, Bisphenol A (BPA).  BPA is a high-production-volume chemical with estrogenic activity which is a component of hard plastic bottles and the epoxy liners used in various canned goods. These are only a few examples of where BPA can be found. In animal models, BPA has been demonstrated to have adverse effects on the development of the uterus, and is also a known is harmful to the fetus. In human cells, BPS has been shown to have the same effects. The fetus is very vulnerable to these “endocrine-disruptive” effects, and avoiding BPA exposure as much as possible is highly recommended. This can be done to some extent by simply avoiding the use of hard plastic bottles and canned goods that are lined with BPA as much as possible. Eating fresh foods rather than canned foods is another way to accomplish this….and it will help one stay healthy in many other ways as well.
 Epigenetics and Longevity  Turritopsis Nutricula  
 (interview with Roger Garcia, D.O.)

Epigenetics and its impact on longevity is important. Epigenetics  means “control above the genes”. The myth in medicine says that we are under complete control of our genes from birth, but in reality, only 5% of our longevity (and our future), is directed to our genes. We know from the “Human Genome Project” that there are 22,688 genes in the Human Genome…that is less than the fruit fly! The difference between the human  and the fruit fly is that we can control our genes where the fruit fly can’t. We can “manipulate” our genes by controlling our environment and surroundings. In this way, we can manipulate our genetic make-up.  There are 2-3 million combinations based on our diet, exercise, mind-body connection (i.e., spirituality), and many other factors that all impact our genes, and ultimately, our longevity. The genetic factors we were born with and the genes of our parents are not what we are “condemned” to live with. We have the ability to change many of these “pre-determined” genetic factor outcomes even within a single generation. In essence, the bad gene expression can be overridden by what you do externally to increase the expression of the good genes. Thus your progeny can now express the resulting actions of the good genes and get the “good genes back”.  For instance, if your father died at an early age from a heart attack or due to heart disease, if you don’t do the things which will lower your risks and improve your health, such as following a better nutrition program, exercise, mind-body relaxation, stress-reduction activities, etc…you may also be condemned to his same fate. So, by following advise here can be very beneficial for your health, longevity, and overall well-being.

 (interview with Robert Berger, MS, MVSc, PhD)

Turritopsis Nutricula is a type of jellyfish and is the only living organism found in nature that is biologically immortal. It has the unique ability to revert back to its polyp (young/infant), stage after reaching its advanced adult stage, and repeat its life cycle indefinitely. Although natural enemies, predators, and various diseases usually don’t allow the majority of this species to live forever, many numbers of this species still do enjoy extended life cycles many times over. When the name “Nutricula” was chosen for our magazine, the concept was to have a publication whose name itself truly defined what the goals and objectives of this magazine and site were to be; to have a comprehensive magazine/about longevity…but not just about living longer, but about having a better, (if not the best), quality of life for the longest time possible. It’s about things one can do to extend and/or increase one’s lifespan…but in a healthy way…through medicine, nutrition, lifestyle, exercise, personal and psychological issues, and even through emotional well-being. It’s about being the best one can be for as long as your lifetime allows.