Cancer Screening: Utilizing Data and Improving Strategy — Expanding Screening to Guide Preventative Medicine

Paul Reller, L.Ac.

Cancer is perhaps the scariest disease facing the patient population. There is a widespread belief that a diagnosis of cancer dooms the patient to suffering and death, and a societal fear has been firmly established, almost a phobia. There is a general belief that only very harsh therapies will save only a lucky few patients, and that eventually medical science will come up with a miracle cure that can be applied to all cancer patients. The real truth is that cell mutation and cancer occurs in almost all bodies, that most cancer goes into remission or is kept in check by the body's own systems, and that in most types of cancer almost all cases detected are benign. We have not found oncogenes specifically responsible for cancer in 50 years of study, and there does not appear to be a simple silver bullet treatment anywhere on the horizon. What we are logically looking for in screening is a way to separate the benign and manageable cancers from those that require an aggressive treatment. Instead, screening has been used by the industry to lump together those patients that shouldn't worry with those that should.

Cancer screening was created to identify the relatively small percent of cases that were life-threatening or that would create serious dysfunction. Today, many cancer experts believe that instead, we have created a system of screening the general population that results in unnecessary treatment for many thousands of people who face little or no actual threat to their health, and in many cases has proven inadequate in identifying the few percent of patients that are seriously threatened in time to save their lives. Public health experts are clamoring for a rethinking of the current screening strategy, and evolving of a more comprehensive screening profile combined with an integration of preventative medicine that truly helps reverse cancer development at the earliest stage. We now know that the two most prevalent cancers in our population, breast and prostate, appear to frequently metastasize when the tissue lesions are small and generally undetectable. In this scenario, healthy prevention would be the key to stopping early metastases.

Public health experts around the world now fear that our system of screening is not only inadequate, but has engendered a public fear and stress that itself is creating health problems and potentially contributing to the breakdown of natural defenses against cancerous cell mutations. The fear of some cancers is now so great that patients are opting to remove their breasts when precancerous cells are detected, even though greater than 99 percent (some say 99.7%) of these so-called precancerous lesions will not develop into a tumor at all. In 2010, long-term studies in Europe found minimal protocol (lumpectomy with a single focused radiation treatment and removal of just the cardinal lymph node) produced the same or better outcomes than the U.S. standard of lumpectomy with extensive lymph node excision and 6 weeks of radiation therapy. Studies have found that a high percentage of women have been steered toward radical mastectomy and breast reconstruction because of the desire to avoid extensive radiation and lymph surgery. The European researchers found this practice to be unwarranted and unethical (see the links to articles on this research below).

The same type of unwarranted fear has been driving men with prostate cancer to opt for more radical procedure than is necessary in many cases. Some men are opting for chemical castration, prostate removal, or insertion of radioactive pellets when a non-specific PSA marker indicates a remote possibility of a prostate cancer creating problems. The details of current long term studies, such as the ERSCP and PLCO are provided below in the section on prostate cancer screening. There has been much concern among public health experts on the effects of this unwarranted fear for men diagnosed with insufficient data to support the diagnosis. A 2009 public health study at Harvard Medical School found that suicide rates for men diagnosed with prostate cancer was 40% higher than the undiagnosed group in the first year, and deaths from stroke or heart attack was more than twice as high among the men in the first month after diagnosis than it was among the cancer-free men. The study authors cited psychological stress caused by cancer diagnosis as the primary factor for these deaths. The way that we look at cancer in our society and the unnecessary generation of fear rather than hope is generating a major health problem all its own. Better screening, individualized analysis, patient education, and the integration of Complementary Medicine to help achieve better survival rates and quality of life would seem to be in order. We have established a blind trust in the medical industry, driven by fear, and they have apparently dropped the ball.

There has been decades of controversy surrounding the reporting of cancer mortality, which many public health experts believes has been used to present a false picture to the public to generate funding and push expensive therapies. Currently, cancer is reported to be the leading cause of death in the United States, yet the figure represents startling facts that are not made clear to the public. The census bureau listed diseases of the heart as the leading cause of death in 2006, and the combination of stroke and heart disease, or cardiovascular cause of death, far exceeds the mortalities attributed to malignant cancer. The classification of malignant cancer as the cause of death occurs in nearly every patient diagnosed with malignant cancer, regardless of the health problem, drug cause, etc. that is primarily responsible for the actual cause of death. The fact that the patient has survived the malignant cancer for years at the time of death in often not taken into consideration. About half of malignant cancer mortalities recorded from 1990 to 2006 occurred for patients over 75 years of age, and only about 17% occurred in patients under 65 years of age. The listing of the cause of death as malignant cancer in the U.S. population per 100,000 during this time frame was 688.2. Cancer is clearly a process associated with aging, and while the population sees cardiovascular deaths as a natural cause of death, we view cancer as a different entity, one that generates great fear compared to cardiovascular disease.

Patients are now seeking better understanding of cancer diagnosis and taking a more pro-active approach to managing their assessment, diagnosis and therapy to find the best individualized outcome. The future of cancer screening will provide an ongoing and complex profile of health concerns that actually drive cancer, identify those with highest risk at an early age, and give the patient and an integrative team of physicians the ability to both prevent cancer progression, as well as identify precisely when the cancerous mutation threatens metastasis. Just as Complementary Medicine has been incorporated into cancer therapy, it will also be integrated into an individualized prevention and remission strategy based on a complex screening profile. Use of screening to provide an individualized profile will allow the patient and team of physicians the chance to utilize conservative care at an early date to decrease risk in an evidence-based manner. This strategy, already adopted in Europe, needs to be pushed by the patient population in the United States. What the patient population wants in the United States is reassurance, not fear.

A Reevaluation of Standard Cancer Screening Practices in 2011

New recommendations for cancer screening in 2010 and 2011 have generated much outcry in the press, but these new recommendations and guidelines are coming after years of delay and review of data, and are being implemented by the most conservative of health organizations and medical groups. These are not radical proponents of change, quack medicine, or controversial sources of information. What changes have been implemented? Examples include the US Preventive Services Task Force (USPSTF), which proposed that mammography screening should be limited to the patient population that shows some benefit, and routine screening for all women should be discontinued. The USPSTF in 2011 proposed 2 more recommendations that concluded that typical prostate screening with the PSA and Gleason index resulted in virtually no improvement in death rates from prostate cancer and instead is very related statistically to harm to the patient with increased stress-related illness, unnecessary procedures and medications, and decreased quality of life. An October, 2011 recommendation cervical cancer screenings recommended against yearly testing with PAP smears and follow-up, and instead recommended standard cervical cancer screening every three years for women aged 21-65. This recommendation was concurrantly supported by the American Cancer Society, working with the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology. These long-awaited changes, already adopted in the European Union and other developed countries, strongly imply that our present system of cancer prevention and screening is not doing much good for the patient population, and in many cases is doing more harm than good to the general population. These recommendations did not come easily, as both the healthcare industry, which profits immensely, and specific patients with cancer who were helped by these screening practices, of course object strongly.

The United States Preventive Services Task Force is a federally mandated part of the Agency for Healthcare Research and Quality (AHRQ) and its parent National Institutes of Health (NIH) and US Department of Health and Human Services, and is made up of an independent panel of non-Federal government experts in preventive and evidence-based medicine from our most prestigious medical institutions, and are practicing primary care providers, including a range of professions from medical doctors in various specialties to clinical nursing specialists. This task force reviews and conducts scientific studies of a broad range of clinical preventive health care services. This task force is almost beyond reproach, and as much effort as is possible has gone into forming a task force independent of special interests.

Another source of changes in cancer screening recommendations is the National Cancer Institute of the NIH, which completed a large population-based randomized clinical trial of ovarian cancer screening which included nearly 80,000 women, and concluded that six years of screening with CA-125 and transvaginal ultrasound yearly did not show any statistically significant benefit in survival with ovarian cancer compared to the usual care with diagnostic investigation when signs and symptoms occurred. This study will be continued for the next few years, ending in 2015. Similar findings are expected with large reviews of other cancers, as the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial encompasses a very large number of patients in all or these areas. These findings finally demonstrate that standard screening practices with radiation and other tests are not what are needed, are not effective, and in fact often do more harm than good to the population as a whole.

What is the message that the public and treating physicians should receive from these studies and recommendations? Namely, that we must rethink our attitudes toward cancer prevention to utilize both actual preventive medicines and dietary and lifestyle changes in public health, and utilize more benign and technological markers for cancer that supply a wealth of information which can be individually assessed to determine a graded cancer risk assessment. More importantly, as these biomarkers of cancer are utilized, patients in early stages of risk should be highly encouraged to utilize Integrative and Complementary Medicine to actually prevent the development of the cancer. To ignore this valuable research because it doesn’t fit into the business plan in standard medicine is a cruel and cynical approach to public health.

Controversies now dominate the subject of cancer screening, and the patient needs to understand the basis for these controversies to make the right choices

In 2010, the track record for standard cancer screening is not good. The two most prevalent cancers that may result in metastases and death, breast and prostate, have generated long-term comprehensive study data that suggests no benefit from standard screening for most age groups, and little benefit for the targeted age groups. An enormous industry has created unnecessary treatment for the patients that do not need any intervention, while the patients that face dire consequences have often not been identified and cured any better than those that just came to the doctor with symptoms and signs. Cancer rates have not significantly improved due to screening, and cancer mortalities remain about the same, or in some cases worse, than when widespread cancer screening started for these cancers. Colorectal screening with colonoscopy and polyp removal has yielded some results, but with this procedure recommended every ten years starting at age 50, it is likely that patient awareness and dietary changes, as well as improved treatments, have produced the greatest results in declining mortality from colorectal cancer.

Of course, this widespread criticism of the standards of cancer screening and treatment in the United States has not gone without an outcry from the oncologists and cancer clinics that earn their living from these practices. An article in the New York Time Magazine of October 9, 2011, explicitly outlines the history of this debate in response to the announcement that the new guidelines for prostate screening that would effectively eliminate the standard practice of using the PSA and the Gleason Score to drive treatment would indeed be implemented in the United States. The article, entitled Do I Have Cancer?, quotes the chief medical and scientific officer of the American Cancer Society, Dr. Otis Webb Brawley: “I’m not against prostate cancer screening. I’m against lying to men. I’m against exaggerating the evidence to get men to get screened. We should tell people what we know, what we don’t know and what we simply believe.” What many of his colleagues believe is that the lucrative practice of cancer screening and treatment should not be questioned, or improved. Dr. Brawley, who is a professor of oncology and epidemiology at Emory University, is not suggesting that men should not get screened for prostate cancer, just that we should utilize screening that is logical, meaningful, and not just geared to increasing the very lucrative treatments that destroy quality of life and needlessly alarm over 90 percent of men that get a positive Gleason score. We should not sacrifice the many for the few, especially when we have better ways to identify patients at real risk of acquiring an agressive prostate cancer.

This difficult question of the risk versus benefit of specific screening practices has been unfairly depicted by standard medicine and the press (which depends upon the large advertising budgets of the pharmaceutical, insurance and medical companies) as a question of whether you are for or against cancer screening. This emotionally charged issue is handled like a religious belief, not a scientific analysis. The history of cancer screening is full of mistakes, and some of these mistakes were corrected. For instance, the New York Times article outlines how screening X-rays were promoted to detect early lung cancer and provide early intervention in the 1970s (http://www.nytimes.com/2011/10/09/magazine/). The clinical outcomes were not positive to many oncology experts with this practice, though, and the use of radiation, a major cause of cancer, to detect cancer, was also in question. A long-term study, the Mayo (Clinic) Lung Project, found that between 1971 and 1983 that there was no difference in death rates from cancer between patients that were screened and those that were not. The researchers also found that the detection of small lung lesions by X-ray resulted in many needless biopsies and other invasive tests, as well as treatment strategies with risks for unclear diagnoses. Of course, some patients that were screened had their lung cancer detected at an early stage, but many more were harmed by the radiation accumulation, complications from tests, and unnecessary treatment. This screening was stopped.

After 10 or 15 years, though, the industry brought back radioactive tests to again screen for lung cancer, this time in the form of CT, or CAT scan, which uses up to 60 X-rays for just one test. The clarity of detection is of course better than X-ray, but the same problem with detecting small calcified lesions in the lung that are most often not cancerous growths, and the subsequent biopsies, other invasive tests, and treatments administered, again creates a risk versus benefit situation that will prove to be negative for the whole patient population. This CT screeening is utilized despite the development of more benign screening techniques, such as specialized MRI, and while screening of high-risk patients over the age of 50 has reduced cancer mortality in this subset of patients, CT screening is now increasingly routine for younger patients without a high risk as well. With the development of other screening technology, radiation is not needed, except in a small subset of patients, and then only with lower radiation spiral CT technology. PCR (polymerase chain reaction) to study specific gene mutations, testing for various biomarkers in sputum and blood, analysis of cells in sputum, fiberoptic examination of bronchial tissues (bronchoscopy), and specialized MRI, are currently being evaluated to improve lung cancer screening. The National Cancer Institute of the NIH states on its website in 2011 that “Currently, there is no generally accepted screening test for lung cancer.” The five year survivability from lung cancer has been stuck at about 12 percent overall since the 1960s, and improved screening is of course necessary to improve these unchanged statistics, which have stayed the same despite advances in the screening and treatment technology.

LungCancer.org states on its website that “Although spiral CT scans can detect tumors in the earliest stages of disease, there is some debate among the medical community about whether this earlier detection ultimately saves lives. Some experts are concerned that (this) screening will lead to overdiagnosis, or the detection of cancers that would not have caused symptoms prior to the patient dying of other causes. Additionally, the procedures, such as needle biopsies, that are required to investigate irregularities on the scans can be quite invasive and have their own risks, such as collapsing a lung. False positives (the test shows something on the patient’s lung even though it may not be cancer) can be common because the test can mistake scar tissue or a benign lump for cancer.” This sums up the most important question that the patient needs to consider, not only in lung cancer, but in prostate and breast cancers as well. The answer to these difficult questions in screening is not whether we give up screening, but rather that we need to develop less risky and more complex screening, and early treatment, as well as improved use of preventive medicine. In the case of prostate cancer, the New York Times Magazine article cited above states that many cancer support groups report that patients are often upset that their doctors did not ask them if they wanted to be screened, did not mention the possible side effects from treatment, and did not adequately discuss the potential adverse effects on health that often results, or the fact that more than 90 percent of patients with a positive biopsy will not have significant symptoms from prostate cancer before they die. The need for a better outcome, improved screening methods, and preventive medicine is real, but in a profit motivated health care industry, this has become difficult.

So far, much cancer screening has not produced significant benefit, but has created many additional risks, unnecessary treatments for many patietns, adverse health effects, stress and alarm, and decreased quality of life. The costs of this often ineffective screening have been enormous, not just in dollars spent and a rising cost of insurance, but in needless suffering by millions of patients that received unnecessary side effects from therapy, and enormous stress and disruption in their lives. Of course, the debate on this topic has been, and continues to be fierce, with statistics generated to support each side. What the public wants is no side taking, just a trusted and objective look at what works best. New strategies need to develop over time to improve this track record, but instead, the industry is tied to old methodology that supports the business, rather than moving on to innovative ideas that single out the few from the many, and offer a more comprehensive package of cancer therapy. Patients are beginning to educate themselves and demand that changes occur in cancer screening, detection, and comprehensive individualized therapy that produces the greatest good with the least harm.

One promising development in cancer screening is the use of protein biomarkers. While protein biomarkers present a complex set of variables that is often difficult to analyze, they will contribute to an individualized screening profile that may better guide appropriate therapies. The CA-125 biomarker is used mainly in detection of ovarian cancer, but has been found unreliable due to the fact that various factors other than cancer may cause an increase in the expression of this protein. Nevertheless, repeated tests and analysis over a period of years has been found to be helpful to distinguish those with greater risk of invasive cancer development, or metastatic cancers. When the profile of CA-125 changes in particular ways for the individual patient, further testing and screening is warranted, such as transvaginal ultrasounds in ovarian cancer. The promise of this protocol is that fewer women would be given unnecessary surgeries or other harsh therapies when cancer is suspected. A long-term study of over 200,000 women has been started in Britain, ending in 2015, with Drs. Karen Lu and Robert Bast authoring. Even before 2015, the use of biomarkers and individualized profiling and analysis will give patients and physicians much more to work with to deliver appropriate preventative medicine and anti-cancer therapies.

What the intelligent and informed patient population, and the responsible physician, wants is not an end to cancer screening, but an overhaul. Individualized thorough intelligence gathering and assessment, harmless screening techniques that provide the best data, and concurrent preventative measures taken for the patients that seem the most at risk, must be combined into a more careful and timely package of care. Screening should not be created just to sell something, but as a true preventative public service that allows the patient to make the best choices and find the most reassurance in these choices. The patient needs to take a more proactive approach to get this accomplished, and encourage a more integrated approach with Complementary Medicine.

Cancer screening is not the same as cancer prevention

Currently, there is a debate in public health over whether long-term studies have shown that the health threats from stress and worry, as well as unnecessary treatment, associated with most standard cancer screening and prevention strategies has created more damage to public health than the often meager statistical benefits of standard screening and prevention. Perhaps the most harmful aspect of cancer screening has been not just the unnecessary treatment, stress, and the array of health problems associated with this stress, but the fact that we believe that screening is prevention, and consequently ignore the subject of real prevention. Since cancer will occur in almost all of our bodies, we need to adopt a system of prevention that is ongoing and comprehensive, and not ignore prevention while we receive screening. True cancer prevention can occur both by attention to healthier mechanisms in our bodies that naturally protect us from cancer and reverse cellular mutation, and also by attention to the environment in which we live, working to eliminate the carcinogenic chemicals in our homes, community and the environment at large, such as our air and water. A less stressful environment may also contribute greatly to the prevention of cancer. Our bodies only have so much potential in them, and when we continually increase the workload, systems will fail, and with failed systems comes disease and cancer. While all of this may seem overwhelming, the effective strategy is to take it one step at a time.

One person that can help you a lot with this comprehensive cancer prevention is the knowledgeable Complementary Medicine physician, or Licensed Acupncturist. More and more study data accumulates each year to help this physician deliver an array of specific herbal chemicals and nutrient medicines, as well as more general treatment to improve health and boost the potential of the immune system and inflammatory regulation to counter cancerous cell mutations. Indirect therapies may also be very helpful. For instance, patients with chronic tissue inflammation should seek soft tissue therapy to resolve this problem and take stress off of the system that also works to prevent and reverse cell mutation and cancer. Hormonal imbalances should be resolved, and a healthy endocrine state restored. Gastric and intestinal dysfunction should be assessed and proper health restored to the stomach, digestive organs, and intestines. All of this therapy, both specific to the cancers that you worry about most, and generalized to the improved function of your body, which always is the best route of cancer prevention and reversal, will reduce risk of acquiring cancer. The healthiest patients will also have the best chance of fighting serious cancers, even metastatic cancers. While even a healthy person will probably acquire cancer at some point in their life, those of us that are unhealthy, or going through an unhealthy and stressful period in our life, are obviously less able to handle the cancer and come out with a positive outcome. Recent studies on cadavers have found that nearly 90% of our bodies have evidence of cancerous growth, and about 47% of these appear to have experienced spontaneous remission without direct therapy. This happened because the systems in their bodies worked, and Complementary Medicine can help you to get these systems to work even better.

Cancer prevention in standard medicine has not utilized its greatest asset, which is the growing number of Complementary Medicine physicians and naturopathic research available and ready to integrate with standard care. One example of cancer prevention gone awry in standard medicine is the advice of nearly all medical doctors to avoid any exposure to direct sun without sunscreen to decrease rates of skin melanoma. An article in the New York Times cited below gives the current statistics of a huge rise in nonmelanoma skin cancers, and past articles have outlined the fairly dramatic rise in melanomas in the last decade. Research now shows us that this advice of total sun avoidance has created a public health problem of Vitamin D3 prohormone deficiency, which is normally produced in the body from healthy cholesterol in circulating blood with just 10 minutes of direct midday sun exposure. When this evidence came to light, most medical groups suggested that a rethinking of the concept of healthy sun exposure was a dangerous concept that was dooming patients to cancer. The reality is that a few minutes of midday sun exposure at lunch is not a threat but a health necessity. The threat of this advice was only the undermining of standard advice and the cozy relationship of the cosmetics industry with dermatology associations. Real cancer prevention is evolving and thoughtful, looking to science to reveal new ways to improve the body's ability to prevent and reverse cancerous cell mutations and enhance our natural defenses. Cancer screening and prevention is a public health issue, and should be directed by a public agency without any ties to industry.

Another aspect of evolving cancer screening that hasn't fulfilled its promise, but that could be used in the future to establish effective preventative medicine is genetic screening. Cancer research was focused on these theoretical cancer genes (oncogenes) for more than 30 years, inhibiting other effective strategies. The goal of this genetic research was to find new miracle drugs for the market. Instead, what we found was more information than we knew what to do with. There are many genes, and sequences of genes, and half genes (alleles), and even epigenes, that may contribute to various cancers, but no specific genes that we can turn off to prevent any cancer. The research does reveal some interesting facts that the patients could utilize, though. For instance, in prostate cancer, in 2009, the Cleveland Clinic website announced that current genetic research has revealed that no single gene accounts for any significant portion of the population inheriting susceptibility to prostate cancer, but that more than six gene mutations have been identified so far with links, although these account for only 5-10% of patients. Identification of such gene mutations may identify those patients that are at higher risk for acquiring prostate cancer at an earlier age, allowing those patients to concentrate on specific preventative measures early in life.

Genetic research could be used to guide and individualize this preventative care. For instance, selenium supplementation has been shown to be helpful in prevention of prostate cancer growth in some patients. Genetic research has revealed that patients with the allele AA COX2 expression had an increased risk with high dosage of selenium, and perhaps responded well to low dosage, while patients with the allele V COX2 expression had a 40% decreased incidence in prostate cancer with supplementation with high dosage of supplemental selenium. This type of information could be used successfully to guide inexpensive and harm free effective preventative medicine. Instead, these findings are now used in a superficial way to scare patients away from selenium supplementation. A neurotic attitude against Complementary Medicine drives such advice. The patient wants the physicians to stop this sort of behavior and work together to create a more thorough and dependable preventative prescription. COX2, or cyclooxygenase enzyme 2, is part of the inflammatory modulating cascade, and reveals that improved inflammatory modulation will be effective in preventing prostate cancer. Current advice for high risk patients is to reduce overconsumption of red meat (arachidonic acid, an omega-6), at about age 45, and consume fresh vegetables higher in lycopene and other healthy preventative nutrients. Examples of high lycopene foods include pink grapefruit, watermelon, carrot juice, and even tomatoes, which contain a small amount. COX2 inhibitors, or modulators, are found in many foods and herbs, and could help our bodies decrease excess expression of this enzyme. Examples of COX2 inhibitors include the chemicals EPA (eicosapentaenoic acid, or omega 3), resveratrol, quercetin, beta-carotene, melatonin, lauric acid, oleanolic acid, apigenin, kaempferol, curcumin, berberine, baicalein, cinnamic acid, boswellic acid, and rosmarinic acid. Many of these chemicals can be prescribed in Complementary Medicine in the form of supplements and herbs. Good use of genetic research in this regard continues to expand, providing real tools for effective preventative strategies.

The 2009 Annual Report by the President's Cancer Panel, a 40 year mandated government guide to overseeing the U.S. cancer strategy, headed by the top three cancer and public health experts in the country, selected by the President, reversed course under President Obama, and finally revealed that prevention was the most promising strategy to decrease cancer incidence and mortality. Breaking with the National Cancer Institute, which has been dominated by the pharmaceutical industry for decades, the Cancer Panel finally focused upon the need to regulate, decrease and eliminate cancer causing chemicals, heavy metal pollutants, and toxins from our environment. While our media corporations distract the American public from the increasing carcinogenic pollution of our country by daily stories vilifying the pollution in China, the truth is that the United States is, and always has been, the most polluted country in the world. Finally, real data is presented in the President's Cancer Panel outlining the extent of carcinogenic pollutants increasing in our air, water, food, home, hospitals, and places of work. Radiation exposure, always at the top of cancer causation, has not been reduced in the past 30 years, predominantly due to the great increase in radiation exposure from medical imaging, such as X-rays and CAT scans. Nearly half of American's radiation exposure, which is accumulative over one's life, now comes from medical imaging, compared to only 18% 30 years ago. Figures such as this point to the blinders that Americans wear when it comes to problems with our own country, and the poor attitude of standard allopathic medicine when it comes to public health. With growing technology there is no excuse for continuing with use of cancer causing agents in our medical industry, our industrial production, our food industry, our farming industry, and especially our energy industry. Hopefully, the government will continue to educate the public, and individuals will take this to heart and find ways to clean up their own bodies by utilizing the increasing research into clearing cancer causing toxins, heavy metal ions, and ionizing radiation from our bodies. Complementary Medicine provides the expert information and guidance, as well as the herbal and nutrient tools to achieve these goals.

Cancer screening needs to take this advice of the leading cancer and public health experts to heart, also. The physician needs to offer more information on cancer causing agents for each individual patient, advising the patient on the importance of diet, avoidance of food with chemicals that could increase cancer risk, such as pesticides, herbicides, preservatives, and radiation (which is used commercially to improve the appearance of food and preserve it). Cancer causing chemicals in household cleaners, garden chemicals, cosmetics, and even solvents and preservatives used on flooring and decks should be avoided. Increased public awareness and education will greatly reduce carcinogenic substances in commercial use, and encourage a market for healthy products and dependable locally grown organic food, which will decrease in price when the market increases and the cost of production becomes more efficient. More information on the anticancer chemistry of foods and herbs is found toward the end of this article, and this an other information about chelation, detoxification, antioxidant clearing, etc. are available on other arthicle on this website. When individuals are screened and increased risk is noted, avoidance of carcinogens is particularly important, and increasing the body's ability to detoxify, clear and chelate potential contributors to cancerous cell mutation may be very important in the overall strategy to decrease risk of cancerous growth. A protocol emphasizing the need for a comprehensive and holistic approach is the only sensible course in reducing cancer risk.

Prostate Cancer screening

“The medical community is slowly turning against P.S.A. screening. Last year, The New England Journal of Medicine published results from the two largest studies of the screening procedure, one in Europe and one in the United States. The results from the American study show that over a period of 7 to 10 years, screening did not reduce the death rate in men 55 and over (the age group of almost all prostate cancer onset). So why is it still used? Because drug companies continue peddling the tests and advocacy groups push (so-called) “prostate cancer awareness” by encouraging men to get screened.” Dr. Richard Ablin, creator of the PSA screening technique, in a New York Times op-ed of March 9, 2010.

Dr. Richard Ablin wrote this op-ed (opinon-editorial) in the New York Times that reflected his opinion that the test had been misused in the United States to support unnecessary treatment that did more harm than good. He wrote this op-ed in response to a rigid refusal by the United States medical industry to consider the findings and recommendations of a long-term European prostate cancer study of 2008, the ERSCP, that was supported by an NIH study in the United States called the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) on prostate-cancer mortality. These European experts concluded that long term studies showed no significant reduction in prostate cancer deaths from the present regimen of screening and therapy, but unnecessary treatment in 98% of prostate cancer patients that diminished quality of life, and called for a new system of individualized evaluation that would do a better job. This report was met with much hostility in the United States, and a political, rather than scientific, response, that reflected a desire to continue with a profitable screening and treatment strategy rather than to change to a more patient-centered approach. Despite the many articles that criticized the new European guidelines for testing and treatment, and now the vilifying of Dr. Ablin for his support of these new guidelines, patients are looking for the actual facts that will help them to choose the best course of action.

The European Randomized Study of Screening for Prostate Cancer (ERSCP) was initiated in the early 1990s to evaluate the long-term effects of screening with prostate-specific antigen (PSA) on the eventual outcomes for patients. PSA is a non-specific glycoprotein marker in the blood circulation that indicates a potential problem with prostate function. PSA is primarily produced in the prostate gland and serves to help liquify the ejaculate and semen to allow the sperm to swim freely to increase chances of fertility. PSA is also a protease, or protein enzyme, that increases the rate of dissolving of coagulation and mucus, and allowing more sperm into the prostate fluid ejaculate. PSA is normally found in blood circulation at very low concentration, and there is some correlation with high PSA levels in blood circulation and the presence of prostate cancer, however, PSA elevation is by no means a clear and certain indicator of prostate cancer. PSA is expected to rise with age, and is expected to spike under a variety of circumstances. In a March 1, 2011 article in the New York Times, a professor or radiation oncology at Harvard, Dr. Anthony D'Amico, confirmed that PSA levels routinely spike with sexual activity, riding on a bicycle or horseback, with bladder or prostate infections, after a colonscopy, an with other types of stimulation. PSA spikes are often the result of differing ways that laboratories perform the PSA testing. PSA is not a true specific antigen to prostate cancer, and this name should be changed. PSA was never intended to be a marker that would confirm prostate cancer, but merely an inexpensive screening that would separate men with risk from those without risk.

Jumping to 2010, from the 1991 initiation of PSA testing, nearly 20 years later, the screening has failed to decrease cancer mortality, which should be a cause for concern. In fact, age-adjusted studies of prostate cancer mortality in the U.S. population have not significantly changed since 1949. The ERSCP study found that for every potentially serious cancer patient found in extensive testing, that 47 men with no risk of mortality from prostate cancer were subjected to unnecessary treatment that resulted in serious health problems, such as loss of sexual function, urinary problems, anxiety, and stress related health problems. There was a call by the experts for a more reasonable screening method. In Europe, medical doctors almost unanimously opted to explore new methodology in prostate cancer detection and treatment, individually assessing each patient for risk and discussing the probable outcome, which for 97% of patients involved a very slow progression of a cancer growth that stayed localized to the prostate, and caused minimal symptoms up until their natural death. It was never suggested that these patients receive no care. It was never suggested that patients with a spreading prostate cancer be denied care. It was never suggested that patients not be given effective prostate screening, which involves manual palpation of the prostate and utilization of tissue testing, such as ultrasound, MRI, and eventual biopsy, if warranted. In the United States, the medical doctors instead increased the dependence on PSA counts to guide harsh therapies, often utilizing chemical castration, or chemical stopping of hormone production, and other anti-hormone therapies, even before there was any evidence of prostate cancer that was driven by hormones. Many other patients are given insertion of radiation pellets and surgical removal of the prostate when it is unclear whether their cancer is indeed threatening, mostly based on outdated PSA screening. Instead of opting for a simpler and more direct approach to screen potentially serious cases, a formula of risk screening was built around the PSA counts that was difficult for even the prostate cancer specialists to understand, and harsh therapies were prescribed for almost every patient with a poor score on these tests.

Normal PSA levels of 4 ng/ml in the circulating blood were established by a single small study in 1986, where the company that was selling the test, Hybritech, distributed the data that claimed that 99% of normal men (472 health and relatively young men were used in the study), maintained a PSA level of 4 or lower. In subsequent studies, it was found that men with a variety of health problems, and even sexual habits, could elevate this PSA count, and that a significant percentage of men with prostate cancer did not have an elevated PSA count (18%). It was also later found that normal PSA in the over age 70 population was higher, at least 7.4. The list of factors that could cause an elevated PSA in the abscence of prostate cancer includes obesity, prostate infection, prostate irritation, benign prostate hyperplasia, recent manual digital exam, recent surgery, and even recent ejaculation. Frequent ejaculation could also account for a percentage of the high PSA counts. The company that did the original study knew these facts and screened the study participants to exclude any of these cases. Medical doctors still do not usually discuss these potential factors that could cause high PSA counts with their patients. Dr. Hablin, in his op-ed article, states that even use of ibuprofen, as well as other over-the-counter drugs, and even other infections in the body unrelated to the prostate, are now known to be able to elevate the PSA levels in testing. Screening guidelines utilizing PSA counts established by the pharmaceutical industry are not adequate to insure accurate results to guide therapy with harsh side effects and diminished quality of life.

Evolution of the current screening protocols in prostate cancer

In the last ten years, a large number of medical doctors read these facts in the United States and suggested that a better system be implemented. It was found that PSA velocity, or the fast rise of PSA counts on multiple repeated tests be used as a more specific marker before alarming the patient and proceeding with drug therapy. This seems perfectly reasonable, yet was rejected outright by most clinics and hospitals. They argued that the PSA velocity would delay treatment, since this testing involves monitoring the PSA for up to a year in most cases (although slow growth implies less threat). Another reasonable tactic suggested by informed and free thinking medical doctors was the use of a free PSA test. Most PSA in blood circulation is bound to protein carriers, and studies revealed that the ratio of free PSA to bound, or total PSA, was a more reliable indicator in long term studies of potential prostate cancer patients. This test marker was also usually not performed and discussed. When it was performed, the patient often was not asked whether they had ejaculated in the last 24 hours, which would raise both the free PSA and total PSA dramatically. If this was discussed, patients report that the question was asked in a casual way, and often the patient was then embarrassed to discuss their sex life, and often said no, with no real idea of the importance of the fact that they had masturbated within 24 hours. What was adopted was the Gleason score, which is difficult for the patient to understand, and sometimes even the medical doctor.

Even in 2011 there is still alarm in the community of prostate cancer experts concerning the number of useless biopsies and misuse of prostate screening tests to generate these unnecessary biopsies, and high incidence of stress and anxiety associated with them and the threat of prostate cancer. An article in the March 1, 2011 New York Times, entitled “Prostate Guidelines Said To Cause Useless Biopsies”, cite the leading experts in the field decrying the current use of prostate cancer screening guidelines to generate useless biopsies. After the larger studies found that the PSA testing and standard one-size-fits-all PSA score, as well as the difficult Gleason Score, were problematic, many oncologists in the U.S. started using the PSA velocity, sometimes alone, as a guideline for suspected prostate cancer and need for a biopsy. The article cites cancer experts at Harvard and Sloan-Kettering, who state that many oncologists in the U.S. are now using guidelines that generates biopsies with a single increase of 0.35 nanograms of PSA in a year, when the PSA is in excess 4.0, and often even when the PSA is normal for a healthy young man, or under 4.0. A single yearly rise in PSA could be attributed to many circumstances, as stated above, which every M.D. understands now, and a rise in PSA, or increase in PSA velocity, alone, routinely occurs in men, as does fluctuation of the PSA. The misuse of the PSA velocity test is now so widespread that Dr. Andrew Vickers of Sloan Kettering, who authored an extensive study of the misuse of PSA velocity in oncology, published in the March 16 issue of the National Cancer Institute, stated that the PSA velocity test should perhaps be eliminated from cancer screening due to the widespread misuse of this test generating scores of unnecessary and useless prostate biopsies. The sage seems endless.

There are now many screening methods other than PSA and Gleason Score to assess prostate cancer. The trans-rectal ultrasound (TRUS) is a safe and effective way for the specialist with minimal training to examine the prostate for small growths and tumors, and monitor cancer growth when detected. Preprostectomy MRI, or combined MRI-MRS (spectroscopy) are also useful in differentiation of clinically significant from clinically insignificant disease. Other markers that have been used are PAP, PSADT, PSA RE-PCR, DHEA, Testosterone, Prolactin, CEA (carcinoembryonic antigen), CGA (chromogranin A), DNA-Ploidy, Ploidy, and NSE (neurospecific enolase). This menu of screening is being developed in Europe to individualize the patient risk and guide an appropriate therapy. These various tests and markers are best used in an individualized manner, providing information and profile that can be utilized over time. Unfortunately, the U.S. has a medical system based on what the insurance company allows, not what is warranted by science, and here this array of tests is rarely approved for payment. Oncologists have given up even requesting it.

What drives the initiation of prostate cancer is different than what drives the rapid growth later in the cycle. Some patients may have different hormonal imbalances that increase risk. While we try to use PSA and Gleason score to identify patients with prostate cancer that is already threatening, some of these other markers could be used to identify patients before the cancer develops into a threatening stage, and gives the integrative team and the patient the time to consider various conservative and preventative strategies. This protocol would put the patient's mind at ease, rather than unnecessarily alarm him, and allow a positive and proactive strategy to decrease risk. Complementary Medicine, and many responsible M.D.s are now turning to other laboratory testing, such as active hormone metabolite and biomarker screenings, to improve the assessment at an early stage and guide preventative care or treatment. The Licensed Acupuncturist can also order these inexpensive tests, which are performed utilizing saliva and veinous blood stick sample collected by the patient. Unfortunately, in most cases, the insurance authorization is still hard to obtain, and many patients pay a reduced price out of pocket to the lab.

The importance of patient education accompanying cancer screening

With cancer screening, patient education should be the first step. When patients are unclear on the procedures and science of cancer screening, fear and anxiety naturally take hold. Underestimation of the ill effects of fear and and anxiety on our health is a common mistake. More and more studies are revealing that such stress contributes to a substantial percentage of health problems in the United States. By increasing empathy and a patient-centered approach, public health researchers are finding that total health care costs can be dramatically decreased. Even in the workplace, recent studies have shown that showing true concern for the workers and decreasing stress at work with simple practices can reduce company healthcare expenses dramatically. This needs to be applied to cancer screening, which has a long history of creating excessive alarm and fear in the patients with little effective patient education.

Patients themselves are beginning to understand that a system that rushes the doctor to make snap decisions on an assembly-line approach leaves them very vulnerable to accepting the wrong therapeutic protocol, and with cancer, this can have devastating results on quality of life. When a high PSA and high Gleason score is seen, the patient should not be alarmed, but rather insist on further detailed study before jumping to the conclusion that a threatening prostate cancer is present. If these investigations lead to a biopsy, the patient should obtain a copy of the oncology report, and if needed, seek a second unbiased opinion. Specific evidence should be presented to the patient that convinces him that the cancer is indeed a fast-growing and threatening type of cancer. The oncology report should also define the cancer cell line and guide the appropriate therapy. Complementary Medicine can be utilized as an adjunct therapy, both to increase success, and to decrease side effects of standard therapies. Keeping calm and being your best advocate will insure that the most intelligent individualized course of therapy is given.

When potential prostate cancer is discovered, the patient needs to know first whether this is a slowly progressing or an aggressive cancer. Treating all cancers as if they are aggressive is not reasonable with the advance in information that we now have. This is a primitive approach that is at odds with long-term study data. Today, we have the capacity to proceed calmly and objectively to discover what type of cancer we have. If the tissue biopsy is performed and the latest technology utilized, much can be determined from the analysis of the cell physiology and anatomy. This analysis is called cytology. In Europe, cell cytology is advancing rapidly, and can individualize the treatment for each patient. Companies now have developed ways to determine which specific chemotherapy will be effective if this is needed. Cytology should reveal whether the prostate cancer is driven by local DHT, the active form of testosterone that is created locally in the tissues and drives excess cancer growth by problems with hormonal receptors. If the cytology does not reveal such prostate specific cancer cell lines, further testing must be performed to see if the prostate cancer has originated in some other part of the body and spread to the prostate. The only reason these tests are not performed in the United States is that insurance commpanies discourage thorough testing and evaluation, and encourage a one-size-fits-all approach to therapy. People with a busines degree are making these medical decisions, not people with a medical degree, and oncologist are forced to go along with these guidelines.

New developments that may lead to an array of prostate cancer markers that could be individually tailored to a cancer profile include the evidence of tissue types in precancerous lesions. All of this information is useful to establish a growth rate prognosis and for an array of therapies to be utilized that are specific to each patient. Naturopathic studies of specific nutrient medicines, and herbal research, much of which has already been performed in China, can be directly applied to cell types in prostate cancer, as well as stages of prostate cancer development. We now know that what initiates the cancer that is DHT driven is different from what speeds the cell growth and metastasis. Specific therapies can be applied from a multidisciplinary standpoint utilizing screening and assessment information, and integrated in the future. Many patients are certainly interested in expanded options, safer therapies, fewer side effects, and the best quality of life in a more thorough approach. Resistance to this this logical development in medicine can be overcome by patient input.

With some knowldege of the situation, the patient is able to intelligently discuss the screening, testing and assessment, and insure that their oncologist is taking the approach that the patient thinks is most reasonable.

Breast Cancer screening

Mammography, or X-ray radiologic study of breast tissue, has long been the trusted screening method for breast cancer, despite years of reasonable objections. X-rays produce radiation, and radiation is the number one cause of cancer cell mutation, and is accumulative in the body. Yearly X-ray analysis has seemed like an illogical methodology given this basic fact, and was widely accepted in the past because there was no better screening method available. In 2009, breast cancer authorities stated that national guidelines should be changed to at least discontinue these mammographies in younger women, due to the conclusions of little or no real benefit by long term study analysis, and the potential for the radiation to add to cancer risk. A similar conclusion was reached for women under 40 in 1999, and was also met with much objection, which caused a reversal of these guideline changes. Once again, the point was not to deny women information with screening, but to enact positive changes to our screening and prevention protocol based on new evidence and technology.

Other alarming news has also surfaced in recent years. Genetic markers were touted as firm indicators of risk for a few years, resulting in a large number of preventative mastectomies that were not justified. Some experts in the field adopted a belief that many women were probably preprogrammed genetically to breast cancer, but most specialists argued against such an assumption. Genetic study has now revealed the complexity of genetic propensity for disease and cancer. Not only are a wide number of genes implicated that must work in a sequence that we do not understand, but there is also an epigenetic control of these various genetic expressions that is even more complicated and hard to analyze. No specific oncogenes have been identified that guarantee that the patient will acquire cancerous mutations. Patients with potential genetic alleles may also have a wide variety of inheritable mechanisms to help prevent the cancerous cell mutations. Genetic study and evolving findings were not used in a responsible manner. This information should have been adding to screening information to carefully piece together an individualized assessment. Instead, the genetics were used to drive a market, and take advantage of a societal fear to rush to unnecessary harsh treatment, all justified by the belief by a few that some women were perhaps biologically predestined to cancer. The belief was conclusively denied by further genetic study.

In 2009, the American Cancer Society stated: “Women have already begun to benefit from advances in understanding the genetic basis of breast cancer. Genetic testing can identify some women who have inherited mutations in the BRCA1 or BRCA2 tumor suppressor genes (or less commonly in other genes such as PTEN or p53). These women can then take steps to reduce their risk of developing breast cancers and to monitor changes in their breasts carefully to find cancer at an earlier, more treatable stage.” Such genetic markers do not doom the patient to breast cancer, but do point to the need for the patient to take a more proactive approach to suppress cancer mutations in their body, and allow the patient and physicians to start preventative medicine at an earlier date.

The fear of breast cancer has driven both patients and doctors to jump to conclusions and adopt harsh preventative measures before all of the information is gathered. In recent years, the discovery of estrogen receptors has created an entirely new adoption of harsh treatment regimens, with drugs that block hormone metabolism. As research on this subject revealed that the hormone conversion in the local tissues was mostly responsible, not the systemic estrogens, and that hormonal imbalances and inflammatory responses were driving an imbalance of cellular receptors that delayed normal cell death, or aptoptosis, creating more of a chance of serious cell mutation, these new findings were largely ignored. Expensive drugs had already been created and marketed based on old information, and guidelines and an industry had been created with tremendous momentum that could not be stopped. There has been a reversal of this widespread adoption of harsh medications based on hormonal receptor study, though, and it has come from an increasingly skeptical patient population. The harsh side effects of hormonal ablation are becoming well known in the society, and a belief in the doctors that assure that these drugs are benign has been undermined. While it is not suggested that women completely abandon hormonal anticancer therapies, there needs to be a more individualized approach that does not overutilize these drugs.

What is the solution to creating more effective cancer screening? Currently, simple palpation exams find the majority of growing tumors, and newer MRI technology is becoming cheaper and shows much promise in detecting very small tumors. Progress needs to be made distinguishing small calcifications into benign and potentially malignant with biopsy and histology. As stated, a menu of exams and markers can be utilized, just as in prostate cancer, to give individualized assessment and guide therapy. The savings in stopping unnecessary care would more than pay for the increased costs of the better screening, and a more conservative integrated care could be initiated for slow growing and less aggressive cancers. Early screening assessment could guide specific therapies utilizing herbal and nutrient chemicals, as well as indicate need for improvement of hormonal balance, metabolic homeostasis, and inflammatory regulation.

A majority of invasive breast carcinomas are thought to evolve from pre-existing benign breast lesions, and currently, 80% of all breast biopsies show benign breast lesions, with a great majority of these not associated with developing breast cancer. The term benign breast lesion encompasses a large array of tissue types, and the recent use of the term precancerous lesions has created much unnecessary alarm. The term in-situ carcinoma for some of these lesions with distinct morphological type has been highly controversial, as these tissues are not technically carcinoma, and many experts have claimed that the use of the term was created purely to cause alarm and sell procedure. In recent years, a growing percentage of all new breast cancers diagnosed and treated are DCIS (ductal carcinoma in situ). New molecular studies have suggested that this tissue type exhibits only one of the potential pathways of the complex mechanisms of breast cancer development. In addition, studies at prestigious cancer clinics, such as Sloan-Kettering, has found that different labs produced different morphological assessment of these in-situ lesions. Still, fear of breast cancer has driven many women to jump to the most radical solution, double mastectomy, despite the fact that even mastectomy might not prevent cancerous growth and spread if the cancer is indeed invasive, and the stress of mastectomy and reconstructive surgery, with implants, actually has the potential to stimulate cancer growth. As always, the guidelines do not reflect the complexity of the situation, and do not adequately consider the individual parameters of each case. There is much a woman can do to decrease risk of developing cancer after the so-called in-situ carcinoma is diagnosed, though, even when mastectomy is chosen, and research in Complementary Medicine should not be ignored in the individualized protocol.

An article in the July 20, 2010 New York Times elucidates the current problem with diagnosis of DCIS. Experts such as Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine, states that “There are studies that show that diagosing these borderline breast lesions occasionally comes down to the flip of a coin. There is a 30-year history of confusion, differences of opinion, and under- and over-treatment.” The link to the full article is presented in additional information below. The readiness of many oncologists to take questionable biopsy results of questionable cancers and present this to patients as firm proof, shows many patients that they need to be wary and adopt a treat and monitor approach, rather than to jump to conclusions and let their fears drive radical decisions.

How can the threats of so-called in-situ carcinoma of the breast, which is actually non-invasive potentially precancerous microlesions in the milk duct tissues of the breast, be explained more clearly and simply to the patient? This is a question that was addressed in a 2010 report published online April 27, 2010, by the Journal of the National Cancer Institute, and reported by the New York Times (link to article below). The biomarkers p16, COX-2, and Ki67 were identified as the key markers for more accurate prediction of risk for these cancers. If the woman tests positive for all 3 markers, a woman has a potential 20% risk of developing an invasive cancer within 8 years. When these 3 markers are negative, the woman has a determined risk of developing invasive cancer of only 4%, while the general population in the age group over 45 being reviewed, has a 3% determined risk. Individualized profiling in the future could also divide these groups more accurately in those more at risk. For women that determine that the risk is less than the harm of standard therapy, there is now an individually tailored safe and effective treatment protocol in Complementary and Integrative Medicine that is growing each year with new research.

What do these important biomarkers now tell us about our bodies? COX-2, or cyclooxygenase-2, is a common inflammatory mediator that helps our immune system determine the rate of inflammatory processes. COX-2 is a protein that is able to synthesize increased prostaglandins, and is useful in the inflammatory cascade to rapidly counter inflammatory processes to moderate them. Overexpression or accumulation of COX-2 may lead to changes in the tissue epithelium and promote growth factors associated with various cancers. In coordination with other chemicals, COX-2 overexpression can also inhibit programmed cell death, or apoptosis, increasing the chance that older cells undergoing normal mutations with aging will become cancerous. Precancerous lesions may overexpress COX-2 to counter chronic inflammation due to irritation by these calcified lesions, and it is found that cells that are stimulated excessively by certain estrogen receptors may also overexpress COX-2. While many breast cancer sites now state that COX-2 is a form of the inflammatory mediator associated with cancer, this is misleading in its implication that COX-2 is not expressed outside of cancer cells. The fact that a number of COX-2 inhibiting drugs were invented (Vioxx et al) for all chronic pain, and in fact taken off of the market due to extreme risk and damage by upsetting the normal inflammatory processes and leading to cardiovascular degeneration, tells us that COX-2 is a widely expressed inflammatory mediator outside of cancerous lesions. There is now a wide array of studies on natural COX-2 inhibitors found in herbal medicine that have proven to be safe and effective. Another biomarker, p16, is a tumor suppressor protein, called cyclin-dependent kinase inhibitor 2A, that plays an important role in regulating the cell cycle and correcting the cell mutations that lead to a variety of cancers, most notably melanomas. Ki67 is a protein that may be necessary for cellular proliferation, and overexpression may therefore by linked to tumor growth. Ki67 will not be seen in all cells of the precancerous lesions, but if it is found in too many of the cells, this is a marker that signifies that the small lesions may develop into a faster growing cancer over time. Understanding of these relevant biomarkers leads to advanced research in ways to safely decrease these cancer processes with herbs and nutrient medicine. Since the development of these cancers is slow, many patients have time to utilize this research and benign therapy to decrease risk.

One important consideration in individualized protocols for women with a higher risk is age. With slow growing cancers and risks well in the future, many women may decide that at an advanced age it may be a choice to try to prevent the cancer with healthier protocols, and avoid the stress of standard therapies, especially the stress of radical mastectomies and radiation. Such stress in the older woman may have serious consequences, and it is hard to determine whether such stress will in fact lead to decreasing the body's natural defenses against cancer. No studies actually examine the potential of harsh therapies to induce cancer. There is no funding for studies that would produce negative data on the therapies. One example of this dilemma is the recent findings that standard CAT scans, which incorporate a relatively high dose of radiation with repeated X-ray slices in tissue study, actually cause thousands of new cases of cancer per year. The U.S. government is finally producing new guidelines to limit the use of CAT scans, and better guidelines to prevent mistakes with inadvertent high dosage of radiation. Radiation therapy itself in cancer protocol has recently been scrutinized and found to result in many cases each year of improper dosages and errors leading to serious injury. The New York Times in 2010 published a series of articles outlining these problems with radiation in therapy. Before this, both patients and physicians seemed to operate on the assumption that radiation in diagnostics and treatment had no significant risks and injury. The patient that is advanced in age takes these factors in consideration as a carefully documented individualized assessment of risk versus benefit is put together. Often, the patient may choose to utilize therapeutic protocol with less risk, even if the proven benefits are not as well documented.

While our science emphasizes study of those women that develop cancer, we largely ignore study of those women who avoid it. Patients are starting to question this emphasis, though, and trying to find out what they can do to be the 97% of women over the age of 45 not expected to develop invasive breast cancer. There is also an abscence of study of those women who are diagnosed with invasive breast cancer and survive beyond 5 years. A New York Times article in the April 26 Science Times follows a woman that is surviving grade 4 invasive breast cancer after 25 years. The article makes clear that there is almost no study of breast cancer survival after 5 years, and her doctors state that they see a small percentage of this most serious type of breast cancer survive, but they have no understanding of what differentiates these patients.

Developing new strategies to avoid unnecessary harm and insure better long term outcomes in patients diagnosed with in-situ benign potentially precancerous breast lesions

Public health authorities across the world are worried about the unnecessary treatment and the stress generated, both physical and mental, engendered by the use of mammography to identify benign in-situ lesions and imply that these lesions are indeed cancer. The term ductal carcinoma in-situ (DCIS) is used to identify very small tissue lesions, usually calcified tissue, that could potentially become cancer. In-situ is a term that means confined to a site, or localized, and ductal refers to the tissues of the breast ducts, rather than the lobules, and is significant because these ductal tissues are more effected by local hormonal stimulation. A majority of the tissue lesions detected by mammography are so-called ductal carcinoma in-situ. This means that there are small tissue lesions that are not spreading in the breast, with no evidence that they are growing, or that these tissue lesions will not be cleared by normal immune responses. Scientific study has also been very critical of the way that risk has been assigned to these DCIS lesions. If analysts rely on an assumption from some small studies that the prevalence in 40 to 50 year old women of DCIS is 9%, then the highest statistical possiblity of cancer mortality, applying general statistics of the population as a whole, is 33%, which is high, but respresents only the worst case scenario. Now, if the researchers rely on data from other small studies that show that the prevalence of DCIS in 40 to 50 year old women is 40%, which is more likely, then the risk of eventual cancer mortality at its worst is 7.5%. Researchers note that this is the worst case scenario statistically, and the actual risk is much lower. The statistics can be used to create unnecessary alarm. And many public health experts have concluded that this is the case, given that 40% of the women diagnosed with DCIS have opted for a double radical mastectomy.

A large scale study in Europe, The European Organisation for Research and Treatment of Cancer (EORTC) completed a large randomized trial of women diagnosed with DCIS and found that with excision and targeted radiation, the rate of recurrence of invasive lesions after 10.5 years was 8%. The rate of incidence of breast cancer in the general population in this age group is about 3%. These statistics represent long-term recurrence of treatable cancers with this protocol. This incidence of recurrence could be further reduced as each year more research reveals a variety of ways that herbal and nutrient medicine could decrease the risks of recurrence. While all of the data on breast cancer pathology and risk is growing more complicated, which naturally generates much stress and worry in the patients diagnosed with DCIS, the actual outcomes with monitoring, standard protocol, and integration of Complementary Medicine, appear to be reassuring. One problem that is increasingly discussed, is that as screening techniques advance, a growing percentage of women after age 40 are found to have these very small calcified lesions. It is now believed by many experts that small calcifications are ordinary findings in a majority of women if we look more thoroughly. As cited, cadaver studies in recent years have found these lesions in multiple sites of the breast milk ducts and lobules in greater than 40% of bodies (see the report cited below). The failure of modern medicine has been the failure to create an assurance that a comprehensive strategy will provide the women diagnosed with precancerous lesions a safe future. Instead of the current atmosphere of fear and dread, better communication and patient education should be adopted to achieve a real understanding that improved standard protocols with Integrative approaches utilizing Complementary Medicine will allow the woman diagnosed with breast cancer to proceed in life with peace of mind.

As stated, at present, the typical treatment suggested with findings of ductal carcinoma in-situ is surgical removal of the tissue and targeted radiation, with or without the use of tamoxifen, as a precautionary strategy. Because this course is now questioned heavily by many experts, a call for improved histology and separation of benign and potential lesions is needed. Further studies, such as the Van Nuys Prognostic Index, have completed large retrospective analyses, and found that be utilizing improved histological classification, analyzing lesion size and morphological classification, that a subset of patients that had received excision alone, without radiation or tamoxifen, had a recurrence rate of lesions of only 2% after 79 months (6.5 years). Another option for these patients where a cancer potential has been noted, but not actually cancer, is to monitor and adopt an agressive strategy with Complementary Medicine to aid the body in prevention of the cancer mutations. Improved histology would allow the women to decide with confidence that this approach is safe. Much research has gone into this strategy. We now know the mechanisms that drive cancer mutations, and each year the research finds more information, and then finds more and more ways that the person can utilize to stop the possiblity of increased cancerous mutation and growth. Hormonal imbalances, inflammatory processes, accumulation of free radical oxidants, accumulation of heavy metal toxins, and other concerns can be addressed with a proper course of safe and effective therapy and lifestyle change as the tissue is monitored. This is the current advice from some of the most respected cancer experts in the United States. This is a more complicated approach than radical mastectomy, but is the sensible and safe approach. Hormonal balance can be assessed and restored with bioidentical hormonal therapy, and a variety of antioxidants, aromatase inhibitors such as DIM and specific herbal formulas, and cancer protectants that are proven in studies, may be taken as the tissue is monitored for threatening changes. In the long run, this type of therapy is healthful and provides not only a potential protection against cancer mutations, both in the breast and other tissues in the body, but potentially increases one's health in other regards.

The study of potential lesions in breast cancer has revealed that there is a relation between the estrogen receptor (ER) and insulin-like growth factor-I (IGF-I) receptor expression in specimens that seem to have the potential to become malignant. Metabolic syndrome seems to play an active role in this type of cancer development, as abdominal obesity in women is associated with higher concentrations of both free estradiol and free IGF-I. Higher concentrations of these hormones may result in hormonal imbalances that drives the estrogen receptor imbalance of alpha and beta, although conversion and creation of hormones in the localized tissue via aromatization is considered the prime driver of the cancer growth once the estrogen receptor imbalance is created. Improved screening and education of the patient with metabolic syndrome, noting levels of free IGF-I, may be part of a more comprehensive screening strategy that is tailored to the individual. Metabolic syndrome may be reviewed on a separate article on this website, and a comprehensive holistic individually tailore treatment strategy is recommended. This is one of the related imbalances in the body that applies to a subset of the women diagnosed with precancerous lesions, and is now creating more ways to create less risk.

Besides treatment to counter metabolic syndrome, which must be approached with a holistic treatment protocol because of its systemic nature and problems in a number of physiological systems in the body, addressing hormonal imbalances, and treating the problems related to the three most important biomarkers in breast cancer evaluation of potentially precancerous in situ lesions, COX-2, p16 and Ki67, are promising ways to utilize Complementary Medicine in an integrated fashion with standard oncology to decrease the risk of developing breast cancer. A number of Chinese medicinal herbs are proven to inhibit or modulate the COX-2 expression, especially those used in the adjunct treatment in cancer. Examples of these herbs studied in the United States, with studies available on the NIH database PbMed.gov, include Trypterygium Wilfordii, Scutellaria baicalensis, Carthamus tinctorius, and Curcuma zedoaria. Milder COX-2 inhibition can be achieved with foods. The USDA database, Dr. Duke's Phytochemical and Ethnobotanical Databases, lists a number of common foods that are found to inhibit cyclooxygenase activity, including tea, thyme, oregano, spearmint, rosemary, sage, bilberry leaf, blueberry, onion, and the common herbs Gingko biloba, Yarrow, Licorice root, and Motherwort (the Chinese herb is called Yi mu cao). Increasingly, new studies are finding herbal chemicals that affect the p16 and Ki67 pathways also. A 2010 study in China found that the herbal chemical epigallocatechin-3-galate in tea could effect demethylation of P16 and inhibit growth of leukemia cells in vitro. A quality green tea, such as Dragonwell, or Long Jing, is recommended, but a variety of quality natural teas, all made from camellia, are effective. A 2002 study at Shanghai medical universities found that a common Chinese tonic formula, Si Jun Zi Tang, significantly reduced stomach cancer cell growth by promoting normal cell apoptosis, or programmed cell death, and affected the Ki67 pathway. Adoption of such dietary regimes and herbal therapy could either aid prevention or treatment of cancer, and is supported by sound research.

Understanding cancer to find the best individualized strategy

The American Cancer Society defines cancer as a group of diseases characterized by uncontrolled growth and spread of abnormal cells. Obviously, in-situ lesions are by their definition not spreading, and should not be classified as carcinoma. Instead of stretching the definition of cancer to increase harsh therapies and worry unnecessarily, we should be looking to better define and differentiate lesions and tumors and find better ways to prevent the development of precancerous states to actual cancer. Standard medicine has spent the last 50 years learning how to attack cancer cells and largely ignored the question of how to correct the environment that governs this abnormal cellular growth and spread. The allopathic approach in medicine dictates the focus on destruction of cancerous cells, while the realm of Complementary Medicine focuses on restoring the holistic physiological environment that allows cell mutations and spread of cancer only when it is out of balance. When our body functions normally, we have the inherent defenses to protect us from excessive cell mutation and unregulated growth, and to fight cancer we need to restore that balance. A new biologic focus in cancer therapy is finally adopting this strategy and finding greater success as allopathic medicine integrates with Complementary medicine, especially TCM.

Our cells multiply and grow in a highly controlled fashion evolved over millions of years. Our genes encode proteins that regulate cell division and growth, and these genes often experience mutation. Our immune system constantly repairs these genetic mutations. By focusing on the promise of oncogenes, or genes that cause cancer, our research has overlooked the bigger picture of genetic repair and maintenance. The search for the magic oncogenes has not produced a cure for cancer, and the focus on inherited genetic mutations has not produced successful therapy. Research largely overlooked fat cells that also play a key role in preventing cancerous cell mutation. Steroid hormones regulate programmed cell death, or apoptosis, and work with many different protein receptors to guarantee that cells are replaced before they form dangerous cancer cells due to excess mutations in aging cells. Hormones operate in a feedback system, and a delicate balance of natural hormones in the whole body is necessary to guarantee proper regulation of apoptosis. The only answer to reversal of cancer in our bodies is to holistically restore the natural balance that protects us every day of our existence.

Is there a clear cure for cancer? The answer is no. The cancer patient is faced with a very complicated and risky course of treatment no matter where they turn. The stress from this decision process, coupled with the stress from the disease and the therapies, is an enormous challenge. Many patients today utilize Complementary Medicine to help them deal with this overwhelming feat of survival, not only to better cope with the phsycial and psychological stress inherent in cancer treatment and recovery, but also to insure that their total protocol of treatment and prevention is optimized. Patients today see real life remarkable recoveries, such as Lance Armstrong's defeat of metastatic cancer and return to win another Tour de France, and find that these patients have utilized a comprehensive Complementary and Integrative medical protocol to achieve almost miraculous success. The key to a complete treatment protocol is in the integration of allopathic and holistic medicines.

Do we advocate Alternative Medicine over standard therapy? The answer should be no, we use the tools at our disposal and integrate them. The decisions in choices of treatment options are complex and should be left completely to the individual patient. There is no alternative to the treatment options that the patient decides are the correct course to save their life. There are a host of complementary and integrative treatment options that improve chances of healthy outcome, decrease risk of harsh therapies, and provide help in maintaining optimal physical and emotional health during the difficult course of therapy. Modern research is also revealing more and more herbal and nutrient chemicals that perform similar tasks in your body that the latest pharmaceuticals perform. Medical doctors and researchers throughout the world are busy utilizing the wealth of pharmacutical research data to find safer and more benign effects that may accomplish the same goals as synthetic pharmaceuticals with herbal extracts and nutrient chemicals. Acupuncture may work synergistically with these herbal and nutrient therapies to help our bodies better utilize these natural therapies. More and more patients and doctors are utilizing this wealth of new research to form a more effective overall treatment plan.

The first thing that the cancer patient must learn is how to utilize an array of integrative medical care to achieve optimum results. Each case has its own set of paramenters, and there are many types of cancer, each with many potential physiological concerns. Cancer is now defined not as a single disease, but a set of various diseases with dysfunctions in an array of systems in the body. This definition implies that a holistic approach is important to the overall treatment strategy in cancer therapies. Modern medicine continues to improve the first line of therapies for malignant cancer, and the first decision is whether the biopsy and oncology report produces evidence that the cancerous cells are benign or malignant, and whether they are fast or slow growing. If the cancer is malignant, or potentially able to spread, and the type of cells are fast growing, realistically, the options available are to 1) destroy or remove as many of the malignant cancer cells as possible and then clean up the damage from treatment, 2) help the body to destroy the tumor cells, and 3) help the body to stop the mechanisms that are causing the cancerous cell mutations. To insure optimum results, the patient may choose to include all three of these strategies into the integrative treatment protocol. If the cancer is not fast growing and malignant, more conservative options should be discussed, and a realistic window of treatment opportunity defined, so that you can utilize less harmful treatment strategies and measure the results before committing to harsh treatments.

Current scientific study has shown that a great number of cancers go into remission, even metastatic cancers. An October 27, 2009 article in the New York Times cited below (additional information) explains the findings published in a recent Journal of the American Medical Association. The intelligent patient will utilize every means possible to enhance the body's ability to slow, stop or reverse the progress of cancerous growths, and Complementary Medicine provides this type of therapy, while standard medicine does not. This is the reason that many of the cutting edge cancer specialists in the world are now utilizing Complementary Medicine in their practice. Collaborating and integrating your care with a physician trained extensively in these therapies is a sensible choice. Allopathic physicians are not trained in herbal medicine, nutrient medicine, acupuncture, stress reduction techniques, and other standard therapies offered in Traditional Chinese Medicine.

How do these therapies work? Besides maintaining and optimizing the natural homeostatic mechanisms against cancer in your body, recent research is opening up the role of herbal therapeutic approaches to stimulate the mechanisms of apoptosis, or single cell death, that your body utilizes to destroy new cancerous cells. As research reveals novel pharmacological approaches to cancer therapies, these approaches are researched to find the same mechanisms triggered by natural chemicals in herbs and foods. Complementary Medicine utilizes this research to improve targeted prescription of herbs and improved knowledge of the preparation of herbal products to achieve these therapeutic goals. Often, the research reveals that herbal approaches are not only without side effect, but as effective as the pharmacological approach.

Recent research at the University of California San Francisco, in collaboration with Peking University in Beijing, China, has confirmed that herbal formulas may be very effective in modulating estrogen receptors that are linked to breast cancer mutations. Initial findings showed that modulation of the estrogen receptors one and two by specific herbal formulas was more effective than the inhibition of estrogen receptor one with tamoxifen. Since the problem with estrogen stimulated tumors lies in the conversion of hormones in local tissues to estradiol, which is regulated by aromatase enzymes and other metabolic and hormonal controls, the dysfunction in the body is a little complicated. Allopathic medicine seeks to block just one step in the cancer causing process, but Complementary Medicine takes a holistic approach and utilizes scientific findings to restore healthy function throughout the entire sequence of steps. A knowledgeable Licensed Acupuncturist can explain this metabolic process and what needs to be accomplished.

There is no single ‘silver bullet’ in this therapy. Instead, there are a lot of choices to consider and incorporate into the right protocol for the individual. The patient needs to find a knowledgeable complimentary med physician or integrative physicians to guide them along this course. The TCM physician, or Licensed Acupuncturist, may provide this knowledge along with herbal protocols, acupuncture, dietary supplements and counseling on diet and lifestyle changes.

Is there proof that these treatments will be effective?

Yes. There is a wealth of sound research supporting acupuncture and herbal medicine in adjunct care with cancer therapies. For Example: Research at the Tumor Immunology Program D030, German Cancer Research Center, Im Neuenhermer Feld 280, 69120 Heidelberg, Germany, published in Blood. 2006 Dec;108(12), found that a chemical in the Chinese herb Huangqin, Wogonin, was able to sensitize malignant blood cells to TNFalpha and TRAIL induced cell death, or apoptosis, without harming other cells. This was accomplished by shifting the TNFalpha induced free radical O2- to the less radical H2O2. This was found to be a significant treatment to enhance the body’s ability to use tumor-necrosis-factor to kill tumor cells. Inducing cell death, or apoptosis, is the goal of radiation and chemotherapy, but this type of herbal approach accomplishes the task without the destruction of surrounding healthy cells. This is one of the many clinical research studies that confirm the efficacy of Chinese herbs in the treatment of cancer. Various research databases, including the NIH PubMed database are available to the public to confirm these studies. The available data is too overwhelming to list in this article.

Researchers at the University of California San Francisco have recently engaged in an official exchange of information with Peking University in China on herbal research and have published one of the first studies to result from this valuable collaboration: Selective Activation of Estrogen Receptor-beta Transcriptional Pathways by an Herbal Extract, published in Endocrinology Vol. 148, No. 2, 538-547: The authors state: "Our results demonstrate that herbal estrogen receptor beta-selective estrogens may be a safer alternative for hormone therapy than estrogens that nonselectively activate both ER subtypes." The TCM herbal formula studied was shown to accomplish the same task as Tamoxifen, a synthetic estrogen that treats both osteoporosis and breast cancer by inhibiting estrogen receptors. Tamoxifen works by selectively binding to one estrogen receptor type to effectively inhibit the effect of estradiol on the other. The chemicals in the herbal formula was found to bind to both estrogen receptors and modulate the responses, recruiting coregulatory proteins that are required for gene activation. The formula did not activate the estrogen receptor alpha-regulated proliferative genes or stimulate breast cancer cell proliferation or tumor formation in animal studies. The herbal formula would thus not induce hot flush or other side effects related to hormonal imbalance that Tamoxifen produces.

How alarmed should the patient be when malignant cancer cells are found?

In the newly published book, The Biology of Cancer, Dr. Robert Weinberg of the Whitehead Institute in Cambridge, MA, points out that in experiments with mice carrying malignant tumors, perhaps a million cancer cells are seeded into the circulation each day, “yet the visible metastases formed in such animals may be counted on the fingers of one hand” (courtesy of a N.Y. Times article). The survival of the metastatic cancer cells is precarious and often depends on inflamed tissues to gain hold, and even when affecting other tissues, most of these cancer cells remain dormant or die. Adjunct therapies to support the health of the patient, regulate inflammatory and immune systems, etc. are thus potentially very beneficial. If you follow where research has led us in Complementary and Integrative Medicine, you should be able to design a sound treatment protocol and feel assured that the malignancy is being kept under control as best as is possible. Your treatment plan must be comprehensive, and should involve all aspects of your life, diet, lifestyle, exercise regimen, a workable therapy schedule, and monitoring via tests. At first this seems overwhelming, but many patients adapt to these routines and therapies in time and find that once a new comprehensive routine is established, the program becomes just another way to live your life, and doesn't really get in the way of your work productivity or enjoyable accomplishments at home. This proactive approach lets you feel assured that you are doing all that you can and thus minimizes alarm and worry.

Research continues to uncover specific ways that herbal chemicals may inhibit malignant spread of cancer. Researchers in 2008 at the University of Alabama at Birmingham's Department of Comprehensive Cancer Center found that the proanthocyanidins of whole grape extract inhibited tumor cell migration and metastases with a number of metabolic mechanisms. These proanthocyanidins inhibited excess nitric oxide and nitric oxid synthase, guanylate synthase, and mitogen-activated protein kinase pathways involved in the cancer cell invasion and migration. This makes whole grape seed extract a potent part of a thorough herbal regimen useful to the Complementary Medicine physician in adjunct treatment of malignant cancer. By itself, this herbal extract will not be enough to insure that the cancer does not spread, but as part of a thorough and comprehensive treatment strategy based on such research, it offers much hope to the cancer patient. Standard medical treatment that is progressive now utilizes a large number of herbal and nutrient therapies in cancer protocol. Medical doctors have received no instruction in medical school concerning these therapies, but do prescribe them based on sound research. Many patients realize that another specialized physician should be added to their cancer team, and this is the professional herbalist and Complementary Medicine physician who has graduated from a medical school that provides 4 years of thorough study in herbal and nutrient medicine. This is the Licensed Acupuncturist.

Do Medical Doctors actually support Complementary and Integrative Medicine in the overall treatment plan?

Dr. Ka-Kit Hui, Dr. Edward K. Hui, MDs, and Michael Francis Johnston, PhD, from UCLA Center for East-west Medicine wrote in Integrative Cancer Therapies, Vol. 5, No. 1, 56-62 (2006): The Potential of a Person-Centered Approach in Caring for Patients with Cancer: A Perspective from UCLA Center for East-West Medicine: "Evolving patient preferences as well as an expanding evidence base for commonly used complementary and alternative medicine therapies for patient with cancer have led to inroads by integrative medicine into clinical oncology. Traditional Chinese Medicine (TCM) has been used in conjunction with conventional biomedicine in the prevention and treatment of cancer in China for several decades. Methods: the authors, through select review of the existing literature and by drawing on clinical experience, describe a person-centered approach to care of patients with cancer that incorporates TCM concepts and techniques. Two cases are used to illustrate how this approach might address unmet needs and enhance quality of life for patients with cancer. Results: TCM's emphasis on a comprehensive understanding of imbalance in various systems and resultant compromise of homeostatic reserve as well as its ability to treat them with distinctive therapeutic modalities can add unique value to the overall management of the patient with cancer. Conclusions: TCM can be used adjunctively to improve quality of life and functional status during a patient's struggle with cancer. An approach integrating both medicines that is guided by scientific evidence, safety, and patient preferences has the potential to improve modern oncologic care."

History in the West: A long history of medical doctors in Europe has established a firm naturopathic foundation of research and theory in the use of Complementary Medicine in cancer therapy:

The foundation of complementary medical therapies in European cancer protocol rests with the German doctor Max Gershon. Dr. Gershon examined the mechanisms of cell mutation and came up with a comprehensive list of therapies. Alone, these therapies may not be enough to significantly reverse the cancerous mutations, but together, the package of therapies has been shown to be very helpful. Many patients with this approach have gone into cancer remission and survived long term. Cancer Therapy: The Results of Fifty Cases is Dr. Gershon’s classic book. Other books available include: The Topic of Cancer, Cancer: A New Breakthrough by Virginia Livingston, author of a number of books. Dr. Gershon utilized diet high in potassium with raw food juices, oxygen therapies, and a variety of techniques combined in naturopathic clinics and hospitals devoted to treatment of the cancer patient.

Unfortunately, or fortunately, depending on your perspective, the subject of Complementary Medicine as adjunct therapy in cancer protocol cannot be covered in a webpage. The research and history of treatment is enormous. What I can present to you on this page is a sample of the subject, and is not representative of the total treatment resources available. The key to effective treatment protocol is the knowledge of your physicians, your choices, and the effective management of the protocol. Not everything that is researched can be utilized at once, and the choice of which protocols to use during which phase of your treatment and recovery is extremely important.

Anticancer nutrient chemicals found in foods and herbs

There are a growing number of unbiased and uncommercial databases that provide the scientific study data available on nutrient chemistry that the patient with increased cancer risk may explore to build a comprehensive strategy to clear cancer risk. The USDA, or Unite States Department of Agriculture, maintains a number of databases, including Dr. Duke's Phytochemical and Ethnobotanical Databases, PubMed, and the growing AHRQ (Agency for Healthcare Research and Quality). While the nutrient chemicals found in foods may not be of significantly high dosage, including these foods in the daily diet provides a steady low dosage that is helpful, and more concentrated dosage is found in medicinal herb extracts. Utilizing these standard databases, I am able to present a portion of the pertinent data on anticancer nutrients in food and herbs below.

Anticancer nutrients related to stomach cancers include sulfur containing carbohydrates such as allyl methyl-di- and trisulfides, found in shallots, onions, and garlic, especially in fresh onions and garlic. These chemicals don't just cause bad breath, but are integral to the body's ability to detoxify our cells. Another sulfide with anticancer activity is diallyl-sulfide, found in asa-foetida and watercress, as well as shallots and garlic. This family of sulfides includes the sulfur amino acid cystine, which is integral to the glutathione metabolism, and to health of the intestinal membranes. The supplement N-acetyl-cysteine is an important related nutrient medicine useful in clinical therapy. Nutrient chemicals found to have anticancer properties related to pancreatic cancer include monolaurin, found in saw palmetto fruit, which is also famous for its use in reducing prostate cancer risk, and contains the anticancer nutrients monomyristin and geraniol also. Unprocessed coconut oil is converted in the human body to monolaurin as well. The anticancer phytohormonal chemicals farnesol and geraniol are found in the garden herbs oregano, thyme, rosemary and ginger root, the herbs cumin, coriander, cardamon and cinnamon, as well as the Chinese herbs, cinnamon bark, frankincense resin, bitter orange peel, black walnut shell extract, crepe myrtle, salvia, vitex, and gotu kola. Teas also include these chemicals, such as the common chamelias, and the herbal teas with spearmint and chamomile. Perillyl-alcohol is a nutrient found in perilla, used as a fresh leaf in Japanese sushi, and found as a dried Chinese herb, and in spearmint, bay leaf, chamomile, and caraway seed.

Diallyl-sulfide is also found to have anticancer properties related to colon cancer, so daily intake of shallots and garlic is an important dietary habit. The nutrient S-allyl-L-cysteine is also an anticancer nutrient found in shallots and relate to the supplement N-Acetyl-Cysteine, already mentioned. Chlorophyll is also an anticancer nutrient related to colon cancer, and fresh organic greens, such as collard and mustard greens, are especially beneficial. Chlorogenic acid is another of these nutrients, and is an important intermediate in the formation of the supernutrients lignins and lignans. Lignins are complex chemicals found in algae and woody herbs, and lignans are phytoestrogens and antioxidants that are proving especially beneficial in cancer prevention and hormonal health. Potent lignans, such as the extract from Norway Spruce patented as NuLignan, have passed human clinical trials in Finland and found to significantly increase the breast cancer preventative enterolactones. Dietary intake of lignans and maintained circulating levels of enterolactone have been found to decrease breast cancer risk in double-blinded placebo studies in a number of countries now. Chlorogenic aci, and intermediate in this metabolism, is found in shallots and garlic, as well as green tea, paprika, cayenne, coriander, flaxseed, walnuts, apples, blueberries, thyme and oregano. A number of Chinese herbs contain Chlorogenic acid, including Astragalus, Siberian ginseng, Salvia, Japanese honeysuckle, Berberis, white mulberry bark, marshmallow root, artemisia absinthia, Vitex, Ashwagandha, and the North American herbs St. Johnswort, Valerian, bilberry, nettle, yarrow, angelica archangelica, arnica, echinacea, goldenseal, lemonbalm, and comfrey. Maintaining the health of the intestines, healthy flora and fauna with effetive probiotics, and consumption of lignans and chlorogenic acid is a prescription for decreased risk of colon cancer. Other nutrient chemicals proven useful include ursolic acid, ferulic acid, and ellagic acid, found in rosemary, thyme, oregano, lemons, oranges, plums, strawberries and barleygrass, as well as a wide variety of Chinese herbs.

Therapy with professional Chinese herbal formulas is thus not only helpful to treat specific problems, but often contains a variety of beneficial nutrient medicinals that are found to have anticancer properties and contribute to a healthy preventative cancer routine. Unlike pharmaceuticals, these herbal formulas have a wide variety of natural chemicals evolved in nature that help the organisms correct cell mutations and modulate inflammatory mechanisms that cause cancer. Treatment with Complementary Medicine is thus a smart move in general for patients with increased cancer risk showing up in future screening protocols, as well as the rest of us, since some form of cancer is likely to occur in almost every body as it ages.

Breast and prostate cancers, which account for a great percentage of cancer deaths each year, are also aided by a number of anticancer nutrients. These include the lycopenes, already mentioned, and phytohormonal nutrients such as beta-sitosterol, catechol, and genistein, which are combined with zinc in a supplement to benefit prostate health. Genistein is one of several potent isoflavones, or flavonoids, found in fava beans, soybeans, and various herbs, including kudzu, psaralea, and Mucuana pruriens. Beta-sitosterol is found in fennel seed, basil, soybean, corn, buckwheat, and the herbs saw palmetto, white mulberry, Salvia, and Ashwagandha. Lutein, a yellow orange pigment in the carotenoid family, such as beta-carotene (carrots, sweet potatoes, cantaloupes, oranges, tangerines), is also a beneficial nutrient chemical with anticancer effects. Lutein is found in green leafy vegetables, such as collard greens, spinach and kale, as well as in egg yolks, and in the herb bilberry, with luteins from this fruit and other herbs commonly used to treat or prevent macular degeneration of the eye as well. Once again, a healthy diet of these fresh foods that are increasingly popular and found in local healthy groceries, as well as periodic treatment with herbal formulas provides a proven and healthy regimen to decrease cancer risk and prevent the worst cancers as you age.

No matter who you are, or how healthy you perceive yourself, as you age you must be aware of the fact that the human body experiences cell mutations, that the environment poses many challenges to your health, and that you can't afford to wait until you are diagnosed with cancer to do something about this health concern. We make choices on a daily basis that may contribute to your future health, and adopting a well informed and intelligent diet and lifestyle is just as important as any decisions you might make. If you want to be successful, look good, be happy, you must stay healthy, and utilizing the information and resources inherent in Complementary and Integrative Medicine is a way for you to utilize individualized cancer screening data and take a proactive approach to preventing cancer.

Information Resources

1. An Op-ed in the New York Times in March of 2010 by the creator of the PSA screening technique, Dr. Richard Ablin, was written to speed up the changes needed in prostate cancer screening, and to quit using PSA as the prime marker for the cancer detection: http://www.nytimes.com/2010/03/10/opinion/10Ablin.html
2. A New England Journal of Medicine article in March of 2009 outlined the findings of the large long-term United States study of prostate cancer screening that showed no reduction in mortality from use of the PSA screening: http://content.nejm.org/cgi/content/full/NEJMoa0810696
3. A New England Journal of Medicine article in March of 2009 outlined the findings of the large long-term European study of prostate cancer screening that showed no reduction in mortality from use of the PSA screening: http://content.nejm.org/cgi/content/full/NEJMoa0810084
4. The NIH (National Institutes of Health) released an official recommendation outline of the National Cancer Institute in March of 2009 concerning prostate cancer screening and statistical data, and concluded that annual screening had not proven beneficial in reducing prostate cancer mortality: http://www.nih.gov/news/health/mar2009/nci-18.htm
5. A 2009 meta-analysis update of studies concerning breast cancer screening with mammography concluded that it was still unclear whether screening does more harm than good, and that it was still only likely, not certain, that mammography screening to date has reduced breast cancer mortality at all: http://www.be-md.ncbi.nlm.nih.gov/pubmed/19821284
6. A Washington Post article in 2008 outlined the findings from a study by the Dana-Furber Cancer Institute and Brigham and Women's Hospital in Boston, that showed that less than 1% of precancerous breast lesions detected will advance to a metastatic breast cancer, and that only a few percent metastatic breast cancers are now untreatable: http://www.washingtonpost.com/wp-dyn/content/article/2008/02/12/AR2008021201809.html
7. A June 7, 2010 article in the New York Times outlines the findings of new European long term studies that show that a minimal protocol of lumpectomy with a single focal radiation treatment and removal of just the cardinal lymph node produces the same or slightly better outcome than the more radical surgical and radiation approaches currently recommended for early stage breast cancer and precancerous lesions called ductal carcinoma in situ: http://www.nytimes.com/2010/06/08/health/08canc.html
8. An article published in JAMA in September of 2009 and outlined in the New York Times in October summarizes scientific findings that we now know that many cancers slow, stop or reverse into remission without standard therapy, the key being how to enhance this natural process with Complementary Medicine: http://www.nytimes.com/2009/10/27/health/27canc.html
9. A March, 2010 article in the New York Times Health section reveals that more and more women are opting to remove both breasts when precancerous lesions are detected because of a lack of clear patient education and a strong fear of cancer: http://query.nytimes.com/gst/fullpage.html?res=9C02EFDD1239F93AA35750C0A9669D8B63&sec=&spon=&pagewanted=1
10. A history of the aggressive blunders in breast cancer screening and why radical mastectomies did not reduce cancer deaths was published in the Annals of Internal Medicine in 1998 (vol.129): http://www.annals.org/content/129/1/74.full
11. A 1997 analysis published in the Annals of Internal Medicine outlines how statistics are used to increase the risk assessment of so-called ductal carcinoma in-situ, and how this drives an overblown fear in the patient: http://www.annals.org/content/127/11/1023.full
12. A July 20, 2010 article in the New York Times explains how precancerous lesions are very difficult to assess, and that many biopsies of 'so-called' ductal carcinoma in situ do not produce firm evidence of even a precancerous lesion, yet are still used to drive a protocol of mastectomy, lumpectomy, and other harsh therapies: http://www.annals.org/content/127/11/1023.full
13. An April, 2010 article in the New York Times outlines the findings published online by the Journal of the National Cancer Institute, which finds that 3 biomarkers, p16, COX-2, and Ki67, are the most important in screening of in-situ precancerous lesions of the breast. When all 3 are positive, there is a 20 percent risk of developing invasive cancer in 8 years, while negative markers reduce risk to 4 percent, just one percentage point over that of the general population: http://www.nytimes.com/2010/07/20/health/20cancer.html
14. Current treatment research from the NIH, National Cancer Institute, outlines the success with current minimal treatment strategies with precancerous lesions called ductal carcinoma in situ. Progress in classification of these precancerous lesions has led to many women showing a recurrence rate of precancerous lesions after 6 years of 2% with excision only, when the lesion is classifed properly and found to be less threatening: http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional/page5#Section_81
15. An article in the New York Times, April 2010, follows women that have survived the worst type of breast cancer for decades: http://well.blogs.nytimes.com/2010/04/27/living-for-years-with-late-stage-cancer/
16. An article in the New York Times, July 15, 2010, reveals that the Obama Health Care Reform will include a mandate that eliminates patient fees for many types of cancer screening, certain routine laboratory tests, and some types of preventative medicine: http://www.nytimes.com/2010/07/15/health/policy/15health.htm
17. Nonmelanoma skin cancer rates incidence is explosive in the United States after a decade of strict advice to avoid sun and always use sunscreen - many experts now feel that the strict sun avoidance and sunscreen use has led to a Vitamin D3 hormone deficiency that actually drives skin cancer: http://www.nytimes.com/2010/03/23/health/research/23patt.html?ref=health
18. Evidence-based herbal medicine: Anticancer and antitumor effects of a common Chinese herb, Huang qin, or Scutellaria baicalensis, conducted in 2003 at the Mount Sinai School of Medicine in New York: http://cancerres.aacrjournals.org/cgi/content/abstract/63/14/4037
19. Anticancer and antitumor effects of a common Chinese herb, Ulmus macrocarpa or davidiana, widely used in Korean herbal medicine: http://www.ncbi.nlm.nih.gov/pubmed/18378057
20. Anticancer and antitumor effects of a common Chinese herb, Ban zhi lian, or Scutellaria barbata: http://www.ncbi.nlm.nih.gov/pubmed/14599863
21. Anticancer and antitumor effects of a common Chinese herb, Yun Zhi, or Coriolus versicolor, commonly called turkeytail mushroom: http://www.ncbi.nlm.nih.gov/pubmed/15183073
22. Further research into the activities that make the Chinese herb, Yun Zhi, or Coriolus versicolor, commonly called turkeytail mushroom, effective against breast cancer cells: http://www.ncbi.nlm.nih.gov/pubmed/15908782
23. Research in Argentina in 2006 found that parthenolide in Magnolia grandiflora and Feverfew was effective in vitro in achieving dose dependant nontoxic cell death of cancerous B-cells in chronic lymphocytic leukemia: http://www.209.85.173.132/search?q=cache:OdzpuJNgUvgJ:www.zsf.jcu.cz/jab/4_3/marin2.pdf+herb+herbal+chronic+lymphocytic+leukemia&cd=36&hl=en&ct=clnk&gl=us&client=firefox-a
24. Research in France in 2006 found that St. Johns' Wort, or Hyperforin, was effective ex vivo in achieving dose dependant nontoxic cell death of cancerous B-cells in chronic lymphocytic leukemia, and also inhibiting the cancer cell capacity to secrete a chemical that stimulates the cancerous creation of new blood vessels: http://www.nature.com/leu/journal/v20/n4/abs/2404134a.html
25. Research in 2008 at the University of Alabama Birmingham's Department of Comprehensive Cancer Center found that proanthocyanidins in whole grape extract prevented the malignant spread of metastatic cancer in a number of novel metabolic ways: http://www3.interscience.wiley.com/journal/121369644/abstract?CRETRY=1&SRETRY=0
26. In 2001, Japanese researchers at Ehime University School of Medicine proved that resveratrol from the Chinese herb Polygonum Cuspidatum (Hu zhang) prevents tumor growth and metastasis in lung cancer, as well as tumor induced neovascularization: http://jn.nutrition.org/cgi/content/full/131/6/1844
27. A 2009 study at the University of Texas found that the herb Trypterygium Wilfordii (Lei gong teng) contains an active chemical that is a potent inhibitor of COX-2 and VEGF, as well as inhibition of the receptors for the thrombin receptor CXCR4, TNF and TGF-beta, making this a potent anticancer agent: http://www.ncbi.nlm.nih.gov/pubmed/19922946

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.