Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Broccoli versus selenium for cancer protection

Data suggests the efficacy of selenium for prevention of colon cancer in humans. The source of selenium may be an important factor as well since selenium in broccoli does not accumulate in the body as fast as other forms of Selenium.

Ine one experiment, rats (n = 45) were assigned to torula yeast-based diets supplemented with the following: 1) no Se; 2) selenium as selenate; 3) selenized broccoli. In another experiment, rats were assigned to same basal diet supplemented with the following: 1) no added Se; 2) selenium as selenite; 3) selenium as as selenite + low Selenium broccoli; and 4) selenized broccoli.

Rats were also fed a chemical carcinogen or control vehicle. Supranutritional amounts of selenium ingested as high selenium broccoli significantly reduced the incidence of preneoplastic aberrant crypts and aberrant crypt foci as compared to other groups.This was despite controlling for the presence or absence of broccoli and for the total amount of selenium ingested.

The authors concluded that the decrease in preneoplastic lesions was due to selenium in high selenium broccoli and not a result of broccoli alone or selenium alone.

This suggests that selenium dervived from high selenium broccoli is metabolized such that it diverts much of the selenium into a pool that protects against against colon cancer.

Do you prefer taking supplements as opposed to fresh vegetables and fruit? Please share your thoughts on this article in context of your dietery habits.

Green tea and colon polyps cancer prevention

Evidence for beneficial effects of green tea continues to grow. Experimental data suggests that green tea is helpful in chemoprevention. Studies in Japanese shows that people who drink greater than 10 cups were day have a decrease in risk of colon cancer.

A recent randomized controlled trial examined the effect of green tea on precancerous colon polyps (adenoma) in patients with history of polyps but cleared on subsequent colonoscopy.

The investigators (Dr. Shimizu and colleagues) used supplemental green tea extract tablets equivalent to increase green tea ingestion from an average of 6 cups (1.5 g green tea extract) daily to 10 cups equivalent (2.5 g green tea extract) by supplemental green tea extract tablets. The controls did not get any supplementation. Follow up colonoscopy was performed after 1 year.

At the end point colonoscopy, colon polyps (adenomas) were detected in 15% of the green tea extract group as compared to 31% in the controls. The size of the adenoma detected in the green tea extract group was also smaller than the ones in controls suggesting that even the polyps detected may have less potential for colorectal cancer.

Are you a fan of green tea or for that matter tea? If not, would news like this lead you to increase your intake of green tea?

When is colon cancer screening not worth it?

Colorectal cancer is preventable and screening saves lives. How long should this periodic screening or surveillance continue during a person's life is controversial and raises health, economic and societal issues and concerns.

Dr. Cary Gross and colleagues from the Robert Wood Johnson Clinical Scholars Program at the Yale University School of Medicine tackled this controversial and emotional issue and recently published their findings in the journal Annals of Internal Medicine (November 2006).

They conducted a retrospective cohort study in patients with prior colorectal cancer using population-based cancer registry with linked administrative claims data. They assessed each patient's chronic illnesses based on Medicare claims. Chronic conditions included myocardial infarction, congestive heart failure, peripheral vascular disease, stroke, COPD, dementia, diabetes, renal or liver failure, AIDS etc.

The overall study sample consisted of 35,755 patients. Not surprisingly, they documented that the life expectancy depended on patient's age and the number of chronic illnesses.

They found that among men diagnosed with stage I cancer (curable form of cancer) at the age of 67 years, the life expectancy was 19 years for those without significant illnesses; it was 12 years for those with 1 or 2 chronic conditions as compared to 7.6 years among those with 3 or more illnesses. The numbers for females were 2, 16 and 7 years respectively.

At the other extreme,, these investigators found that if same cancer was diagnosed at the age of 81 years with no concurrent medical illness, the life expectancy was 10 and 14 years among men and women respectively.

They concluded that coexisting chronic illness results in significant reduction in life expectancy after diagnosis of early-stage colorectal cancer. Further screening among such patients should depend upon the overall health of the patient.

These recommendations are controversial since these are based on a retrospective examination of data. Each patient is different and statistical averages may not apply to each and everyone. In addition, we should also partner with the patient and take into account his/her expectations and desired quality of life.

Lets us not forget that healthy diet such as fruits, vegetables, curry and calcium contribute to lower risk for colon cancer.

Are you above the age of 50 years? Have you had your colorectal cancer screening?

Plant diet for prostate cancer?

Cancer of prostate is extremely common as men grow older. Controversy surrounds various treatment modalities. If the patient receives treatment, a rising PSA level after treatment for cancer prostate is a marker for disease recurrence.

Dr. Saxe and colleagues from University of California, San Diego sought to examine if a plant-based diet plus stress management training could be beneficial to the patients. A rise of PSA was used a marker for disease progression. Fourteen patients with recurrent prostate cancer were recruited for this 6-month trial. The authors published their findings in Sept 2006.

These investigators found that the rate of PSA rise decreased significantly as a result of the intervention suggesting less progression or worsening of disease. In fact, median PSA doubling time increased from 11.9 months before the study to 112 months during the intervention period.

This pilot study confirms the negative impact of western diet on the prostate cancer and further reinforces the importance of plant food as a natural antineoplastic intervention.

What are your thoughts on predominantly plant food diet versus western diet? Do you know of anyone who may have benefited from diet intervention?

Green tea heals breast cancer

Numerous studies have documented the beneficial effects of green tea on health including prevention of breast cancer. You might ask, what about the patients who already have breast cancer?

Here is a recent study that shows that the combination of green tea and tamoxifen (a common chemotherapeutic agent used for certain breast cancers) is better than either agent alone.

Dr. Sartippour and colleagues from the from the University of California Los Angeles Medical Center in Los Angeles published in the journal Carcinogenesis (June 2006).

These investigators found green tea potentiated the inhibitory effects of tamoxifen on human breast cells in vitro. In addition, the mice treated with both green tea and tamoxifen had the smallest tumor size as compared to use of either agent.

This study gives us one more reason to sing praises of green tea. Do you drink green tea? I do.