Food that prevent cancer

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Killing cancer softly: New approach halts tumor growth

One of the reasons that cancer is so hard to beat is the way that it ropes our immune system into working against us. Treatment kills off some cancer cells, but what’s left behind can “trick” our immune system into helping tumors to form. New research may have found a way to break this vicious circle.

Share on PinterestSometimes our immune system helps cancer cells (shown here) to spread.

In what has been referred to as the “tumor growth paradox,” killing off cancer cells can sometimes cause more cancer cells to spread.

This occurs because the cellular debris that is left behind triggers an inflammatory response from our immune system, which, in turn, can stimulate the production of more cancer cells.

But researchers may now have found a way out of this conundrum. A new study has found that resolvins — compounds naturally secreted by our body in order to stop the inflammatory response — can stop tumors from growing when such growth is induced by cellular waste.

The research was led by Sui Huang, from the Institute of Systems Biology in Seattle, WA, as well as Charles N. Serhan, from the Brigham and Women’s Hospital at Harvard Medical School, Mark Kieran, from the Dana-Farber Cancer Institute, and Dipak Panigrahy, from the Beth Israel Deaconess Medical Center, all of which are in Boston, MA.

Megan Sulciner is the first author of the paper, and the findings were published in The Journal of Experimental Medicine.

Conventional therapy’s ‘double-edged sword’

Sulciner and her colleagues used cytotoxic treatment and other targeted drugs to kill off laboratory-cultured cancer cells. The resulting cellular debris was injected into mice. The rodents already had a few cancer cells in them, but these were not enough to promote tumor growth on their own.

The researchers also treated mice with traditional chemotherapy drugs.

Both approaches stimulated the spread of cancer cells and boosted their ability to grow tumors. Debris-induced tumor growth could be seen both in vivo and in the cultured cells.

The study revealed that a lipid called phosphatidylserine — which is found on the surface of dead and stressed cells — makes the immune cells release pro-inflammatory cytokines.

The lead study authors spoke to Medical News Today about their findings and the mechanisms underlying them.

“Our studies,” they explained, “along with others, show that traditional cancer therapy may be a ‘double-edged sword,’ wherein the very treatment used to cure cancer is also helping it survive and grow.”

Although aimed at killing cancer cells, these therapies leave behind “tumor cell debris,” which, the researchers explained, “generates a ‘cytokine storm’ of pro-inflammatory pro-tumorigenic cytokines.”

The few cancer cells that do survive treatment, “combined with an inflammatory setting induced by tumor cell debris, may result in the ‘perfect storm’ for cancer progression. Therefore, conventional chemotherapy may contribute to tumor relapse,” explained the authors.

“The findings underscore the old idea that killing cancer cells with more and more effective drugs may backfire,” added Huang.

“The tumor tissue is a reactive system that turns cell-killing therapy into double-edge swords: the more you kill the more you may stimulate the surviving tumor cells,” he added.

Huang explained, “Dead-cell stimulated growth is naturally a part of the tissue regeneration cycle; debris is interpreted by the tissue as injury signal and stimulates wound healing and regeneration.”

“Whether a cytotoxic treatment is successful or not,” he added, “hinges on hitting a small window of opportunity: when the net kill effect is stronger than the stimulatory of the dead cells that treatment creates.”

The study’s lead authors said:

“Overcoming the dilemma of debris-induced tumor progression is paramount if we are to prevent tumor recurrence of treatment-resistant tumors — the major reason for failure of cancer therapy.”

Resolvins ‘kill cancer gently’

In order to address the challenge of this double-edged sword, the researchers treated the rodents with small amounts of resolvins. Resolvins are “a natural product of tissue that serves as a stop signal to end the inflammatory process,” the authors told MNT.

These chemical compounds were, in fact, discovered in a study led by co-lead study author Serhan a few years ago.

The treatment with resolvins stopped the debris-induced tumor growth and blocked the cancer cells from spreading. Additionally, resolvins boosted the activity of various anti-cancer drugs, making them more effective in their fight against tumors.

Huang also spoke to MNT about the clinical implications of the study:

“In brief, we learn that when it comes to cancer therapy: ‘Thou shall not kill — or kill gently and remove dead bodies immediately.'”

“his means that gentler killing or stopping the endless run-away regeneration cycle could be useful: this naturally leads to the use of inflammation-clearing resolvins,” he added.

Resolvins are already being clinically tested for their therapeutic properties in other illnesses, the authors note.

Huang says, “Targeting the resolvin pathways provides an entirely new, non-toxic, and non-immunosuppressive approach to cancer therapy.”

Huang also shared with MNT readers some of their directions for future research, saying, “We need to find evidence from clinical studies that the same principles that we found in mice (although using human cells in some cases) to human cancer.”

A new way to stop cancer cells from killing their healthy neighbors

Credit: CC0 Public Domain

One of the reasons cancer cells are so robust against the body’s natural defenses is that they are in fact human cells, and as such they have the innate machinery not only to trick the body’s defense and maintenance systems, but even to hijack them. Therefore, discovering cancer cells’ full “bag of tricks” is key for fighting cancer.

Eduardo Moreno, principal investigator at the Champalimaud Centre for the Unknown, in Lisbon, Portugal, has taken an important step in this direction by discovering one new such “trick”: a cell-competition mechanism which he has named “fitness fingerprints”.

“We first identified this ‘fitness fingerprints’ mechanism in the model animal Drosophila melanogaster (the common fruit fly), in 2010, and now, in this new study published in the journal Nature, we were able to prove that it also exists in humans and that blocking it halts the growth of human cancer cells”, says Moreno.

Bad neighbours

Moreno and his team discovered that neighbouring cells in the body are constantly evaluating each other’s fitness level by using special markers that each cell exhibits on its surface. “We found that there are actually two types of markers: ‘Win’ fitness fingerprints, which signify that the cell is young and healthy and ‘Lose’ fitness fingerprints, which signify that the cell is old or damaged”, Moreno explains. “If a cell is less fit than its neighbours, meaning that it either has less Win or more Lose than them, then they eliminate it, thereby ensuring the health and integrity of the tissue as a whole.”

According to Moreno, his team found that this process is important for proper development, tissue regeneration after injury and to prevent premature aging, but that it can also be hijacked for tumour growth.

“Cancer cells use these fitness fingerprints to disguise themselves as super-fit cells that have relatively many more Win fitness fingerprints on their surface . This makes the normal cells that surround cancer cells appear less healthy by comparison. In this way, cancer cells trick their healthy neighbours and bring about their death, consequently destroying the tissue and making room for tumour expansion.”

When fitness fingerprints were identified by Moreno’s group in the fruit fly, it was not known whether this cell competition mechanism would be conserved in humans, as it is possible that different animals use different strategies to detect unwanted cells. In fact, Moreno suspected that this mechanism might not be conserved.

“Fitness fingerprints can be very useful, but they also carry a significant cancer risk since they make tumours more aggressive. Such a tradeoff may be acceptable for short-lived animals such as the fruit fly, but for long lived animals such as humans it might be too risky”, he points out. However, following a series of experiments in human cancer cells, they found that we humans possess this double-edged mechanism after all.

Fitness fingerprints in human cancer

To find out whether human cells express fitness fingerprints and whether they are involved in cancer, two researchers in the lab, Rajan Gogna and Esha Madan, performed a series of experiments. They began by identifying the gene that codes for fitness fingerprints in the human genome. Once the gene was identified, they saw that it actually codes for four different types of fitness fingerprints: two types of Win fitness fingerprints and two types of Lose fitness fingerprints.

Next, to observe whether the fitness fingerprints impact cancer growth, the team analysed the expression of these four types in different types of tissues: malignant cancer (breast and colon), benign tumors (breast and colon), tissue adjacent to the tumour and normal tissue.

Their analysis revealed several striking findings: in normal tissue, the expression of Win was overall quite sparse, and expression of Lose was even lower. In contrast, the expression of Win was significantly increased in all tumors, with higher levels in malignant tumors than in benign.

But more alarmingly, tumours seemed to be transforming the fitness level exhibited by the neighboring tissue to their advantage: “expression of Lose was significantly higher in tissue adjacent to tumors, when compared to normal tissue. Moreover, Lose levels were higher in tissue adjacent to malignant tumors than around benign tumours”, Gogna explains. “In fact, further statistical analysis showed that expression levels of Win in cancer and Lose in the neighbouring tissue can predict cancer malignancy accurately 86.3% of the time.”

On the road to potential therapies

The team’s findings strongly suggested that high expression of Win fingerprints in the tumor, in association with high expression of Lose in the surrounding tissue, is a prerequisite for tumor growth. So they decided to test the effect of blocking this mechanism. To do that, they implanted grafts from human tumours in mice and knocked out (or cancelled), the expression of fitness fingerprints.

The results were encouraging: “we found that this manipulation significantly reduced the volume of the tumours, showing that it diminished the destructive power of the tumour against its host tissue. However, this approach alone does not eliminate the cancer cells, just slows down their progress”, Madan explains.

Next, to test the full therapeutic potential of this approach, the team decided to combine blocking fitness fingerprints expression with chemotherapy. This two-pronged approach was very successful: “we were able to further reduce, and in some cases completely eliminate, tumorigenesis!”, says Gogna.

According to Moreno, this is yet another example of basic, curiosity-based research that ends up having important implications for human health. “When we began studying cell competition in the fruit fly, we were addressing it as a basic biology question: how do tissues eliminate viable, but suboptimal, cells. From there to potential cancer therapies seems like an almost unlikely development, but this is how research works; you start with the curiosity to know how things work and from there, sometimes, you find yourself on the road to potential novel therapies.”

Next, Moreno’s team is planning to study this mechanism more deeply, while continuing to collaborate with clinicians for the development of future cancer drugs. “These findings are very encouraging, but they are still preliminary and it will be some years before we are able to use them to help cancer patients”, he concludes.

Explore further

Slug, a stem cell regulator, keeps breast cells healthy by promoting repair of DNA damage More information: Flower isoforms promote competitive growth in cancer, Nature (2019). DOI: 10.1038/s41586-019-1429-3 Journal information: Nature Provided by Champalimaud Centre for the Unknown Citation: A new way to stop cancer cells from killing their healthy neighbors (2019, July 24) retrieved 2 February 2020 from https://medicalxpress.com/news/2019-07-cancer-cells-healthy-neighbors.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Managing Cancer as a Chronic Illness

Cancer isn’t always a one-time event. Cancer can be closely watched and treated, but sometimes it never completely goes away. It can be a chronic (ongoing) illness, much like diabetes or heart disease. This is often the case with certain cancer types, such as ovarian cancer, chronic leukemias, and some lymphomas. Sometimes cancers that have spread or have come back in other parts of the body, like metastatic breast or prostate cancer, also become chronic cancers.

The cancer may be controlled with treatment, meaning it might seem to go away or stay the same. The cancer may not grow or spread as long as you’re getting treatment. Sometimes when treatment shrinks the cancer, you can take a break until the cancer starts to grow again. But in either of these cases the cancer is still there – it doesn’t go away and stay away – it’s not cured.

Living with cancer is different from living after cancer. And it’s becoming more common every day.

How is chronic cancer described?

A doctor may use the term controlled if tests or scans show that the cancer is not changing over time. Another way of defining control would be calling the disease stable. Cancers like this are watched closely to be sure that they don’t start growing.

The cycle of recurrence and remission

Most chronic cancers cannot be cured, but some can be controlled for months or even years. In fact, there’s always a chance that cancer will go into remission. There are different kinds of remission.

  • When a treatment completely gets rid of all tumors that could be measured or seen on a test, it’s called a complete response or complete remission.
  • A partial response or partial remission means the cancer partly responded to treatment, but still did not go away. A partial response is most often defined as at least a 50% reduction in measurable tumor. Here, when we refer to a remission it will generally mean a partial remission.

To qualify as either type of remission, the absence of tumor or reduction in the size of the tumor must last for at least one month. There’s no way to tell how long a remission will last, so remission does not mean the cancer definitely has been cured.

Some cancers (for example, ovarian), have a natural tendency of recurrence and remission. Often, this repeating cycle of growing, shrinking, and stabilizing can mean survival for many years during which the cancer can be managed as a chronic illness. Treatment can be used to control the cancer, help relieve symptoms, and help you live longer.

Progression

Cancers that aren’t changing may be called stable disease. When cancer grows, spreads, or gets worse it’s called cancer progression. When cancer comes out of remission it’s said to have progressed. In the case of chronic cancers, recurrence and progression can mean much the same thing.

Progression may be a sign that you need to start treatment again to get the cancer back into remission. If the cancer progresses during or soon after treatment, it may mean that a different treatment may be needed.

Progression and recurrence occur when the treatment doesn’t kill all of the cancer cells. Even if most of the cancer cells were killed, some were either not affected or were able to change enough to survive the treatment. These cancer cells can then grow and divide enough to show up on tests again.

How is chronic cancer treated?

Most people want to do anything possible to treat cancer, whether it’s the first treatment or the second or third one. Your doctor will talk to you about your treatment options. You may also decide to get a second opinion or get treated at a comprehensive cancer center that has more experience with your type of cancer. There may be clinical trials available, too.

Some people get some of the same types of treatment that they had the first time (for instance, surgery or chemo), but some treatments may be less helpful as the cancer progresses. Treatment decisions are based on the type of disease, location of the cancer, amount of cancer, extent of spread, your overall health, and your personal wishes.

Chemotherapy

Over the long term, cancers are usually treated with chemotherapy (chemo) in 1 of 2 ways.

  • Chemo is given on a regular schedule to keep the cancer under control. This is also called maintenance chemo. This may help curb spread and prolong survival.
  • As another option, chemo may only be given when the cancer becomes active again. The cancer is watched closely with things like imaging tests and blood tests; chemo is started when things change.

Another thing to think about is that cancer cells can become resistant to chemo. The tumors that keep coming back often do not respond to treatment as well as the first tumors did. For example, if the cancer comes back within a year or 2 of getting chemo, it may be resistant to this type of chemo and another drug may be a better option. Sometimes doctors will say, “You’ve already had this drug, so we need to try another one.” This can mean they think you’ve gotten all the help you can from a certain type of drug and another one will probably better kill the cancer cells because it works in a different way.

Sometimes your doctor will not want to use a certain drug because of the risk of a certain side effect, or because you have had that drug before. For instance, some chemo drugs can cause heart problems or nerve damage in your hands and feet To keep giving you that same drug would risk making those problems worse or even lead to permanent damage.

Making treatment choices

Ask your doctor why a certain course of treatment is recommended at this time. Do you have 2 or 3 treatment options? Find out what you can expect to happen with each treatment. Discuss these choices with your cancer care team, with members of your support group, and especially with members of your family. Then you can make the best decision for you.

“She may not be able to cure my cancer, but my doctor says she’ll help me buy as much time as possible. I’m good with that – I’ll take each day as it comes.”
-Stan, living with CML

How long can treatment go on?

This is a very good question to ask, but one that’s very hard to answer. There’s no way to give an exact time limit. The answer depends entirely on your situation and many factors, such as:

  • The type of cancer you have
  • The treatment schedule or plan
  • The length of time between cancer recurrences
  • The aggressiveness of the cancer cell type
  • Your age
  • Your overall health
  • How well you tolerate treatment
  • How well the cancer responds to treatment
  • The types of treatment you get

Because there are no guarantees that you can hold on to, it can be hard to cope with chronic cancer. Talk to your doctor and the rest of your cancer care team about any questions or concerns you have. They know your situation best and may be able to give you some idea of what to expect.

How do I know if I should keep getting treatment?

How much is treatment helping?

For some people, getting cancer treatment helps them feel better and stronger. It also helps control the cancer so they can live longer. But for others, being in treatment works the opposite way – they may reach a point where it only makes them feel worse. Side effects might keep you from enjoying the life you have left. Only you can decide how you want to live your life. Of course, you’ll want to know how your family feels about it, too. Their feelings are important since they are living through the cancer with you. But keep in mind, the final decision is yours.

Do the benefits outweigh the side effects?

When a person has had many different treatments that didn’t help stop the cancer, it may mean that it’s become resistant to all treatment. At this time you might want to weigh the possible limited benefit of a new treatment against the possible downsides, including the stress of getting treatment and the side effects that go with it. Everyone has a different way of looking at this. Talk to your cancer care team about what you can expect from treatment. They can help you make the best decision for yourself and your family.

What is palliative care?

Palliative care focuses on relief of physical and emotional symptoms related to illness– it’s not expected to treat the cancer or other disease. The goal of palliative care is to make your life the best it can be at any time- before treatment, during treatment or after treatment.

This means that symptoms like nausea, pain, tiredness, or shortness of breath are treated and controlled. Palliative care also helps with emotional symptoms such as stress and depression. Sometimes medicines are used, but other types of treatment such as physical therapy and counseling may also be used.

Your cancer care team may include providers who are specially trained in palliative care. If you need help finding good palliative care options, call us.

What is hospice care?

If at some point treatment can no longer control the cancer or the benefits no longer outweigh the side effects, you may feel better with hospice care. The hospice philosophy accepts death as the final stage of life and does not try to stop it or speed it up. The goal of hospice is to help patients live as alertly and comfortably as possible during their last days. Most of the time, hospice care is given at home. It can also be given in hospitals, nursing homes, and hospice houses. Your cancer may cause symptoms or problems that need attention, and hospice focuses on your comfort. If you’d like to learn more about this, see Hospice Care.

What’s “normal” about living with cancer?

The first few months of cancer treatment are a time of change. But when you’re living with cancer that doesn’t go away you may feel like you’re stuck in this change – you don’t know what to expect or what’s going to happen next.

Living with cancer is not so much about “getting back to normal” as it is learning what’s normal for you now. People often say that life has new meaning or that they look at things differently now. Every day takes on new meaning.

Your new “normal” may include making changes in the way you eat, the things you do, and your sources of support. It may mean fitting cancer treatments into your work and vacation schedule. It will mean making treatment part of your everyday life – treatments that you may be getting for the rest of your life.

“Cancer is just part of my life now, and I always try to have hope.”
-Marisol, living with ovarian cancer

Repeated recurrences, often with shorter time periods in between remissions, can become discouraging and exhausting. It can be even more discouraging if the cancer never goes away at all. The question of whether to keep treating cancer that doesn’t go away or comes back again and again is a valid one. Your choices about continuing treatment are personal and based on your needs, wishes, and abilities. There’s no right or wrong decision on how to handle this phase of the illness.

Still, it’s important to know that even those who are not cured of cancer may go on living for months or years, even though there may be changes in their lives. Many families adjust to this kind of treatment schedule.

Having a cancer that cannot be cured doesn’t put you beyond hope or help; you may be living with a disease that can be treated and controlled for a fairly long time.

Living with uncertainty

Here are some ideas that have helped others feel more hopeful and deal with the uncertainty and fear of cancer that doesn’t go away:

  • Be informed. Learn what you can do for your health now and about the services available to you and your loved ones. This can give you a greater sense of control.
  • Be aware that you do not have control over some aspects of your cancer. It helps to accept this rather than fight it.
  • Be aware of your fears, but practice letting them go. It’s normal for these thoughts to enter your mind, but you don’t have to keep them there. Some people picture them floating away, or being vaporized. Others turn them over to a higher power to handle. However you do it, letting them go can free you from wasting time and energy needlessly worrying.
  • Express feelings of fear or uncertainty with a trusted friend or counselor. Being open and dealing with emotions helps many people feel less worried and better able enjoy each day. People have found that when they express strong feelings, like anger and fear, they’re better able to let go of these feelings. Thinking and talking about your feelings can be hard. If you find cancer is taking over your life, it may be helpful to find a way to express your feelings.
  • Enjoy the present moment rather than thinking of an uncertain future or a difficult past. If you can find a way to be peaceful inside yourself, even for a few minutes a day, you can start to recall that peace when other things are happening – when life is busy, scary, and confusing.
  • Make time for what you really want. You may find yourself thinking about all the things you’ve always wanted to do but never made time for. It’s OK to pursue these things, and don’t forget to enjoy everyday pleasures and have fun, too.
  • Work toward having a positive attitude, which can help you feel better about life even if a cure is out of reach. Nearly everyone can find things to feel grateful for or hopeful about. But don’t try to be upbeat or positive all the time – no one is! You need to pay attention to your feelings, even the so-called “negative” ones. You’re allowed to have bad days, feel sad or angry, or grieve whenever you need to.
  • Use your energy to focus on what you can do now to stay as healthy as possible. Try to make healthy changes in what you eat. If you’re a smoker, this is a good time to quit, and encourage others to quit with you.
  • Find ways to relax and enjoy time alone and with others.
  • Exercise and be as active as you can. Talk with your cancer care team about what’s realistic for you.

Control what you can. Some people say that putting their lives in order makes them feel less fearful. Being involved in your health care, trying to find your “new normal,” and making changes in your lifestyle are among the things you can control. Even setting a daily schedule can give you more power. And while no one can control every thought, some say they’ve resolved to not dwell on the fearful ones.

Grief and loss

It’s normal to feel sad when you find out that the cancer cannot be cured. This sadness may not go away, even if you know that there’s a good chance you can live a long time with cancer. You may find yourself grieving the loss of what you thought would be your future. This is hard for anyone to handle without emotional support.

Grief can affect a person physically, emotionally, and mentally. It can interfere with everyday activities. It takes time and energy to adjust to these major changes in your life. Many people find it helps to have people they can talk to about all these things. If no one comes to mind, you might want to think about finding a counselor or support group. (See “Getting support” below.)

Dealing with depression

Some degree of depression and anxiety is common in people who are coping with cancer every day. But when a person is emotionally upset for a long time and is having trouble with their day-to-day activities, they may have depression or severe anxiety that needs medical attention. These problems can cause great distress and make it harder for you to enjoy life and follow a treatment schedule.

Even if you are clinically depressed or anxious, you have some things going for you:

  • Depression can often be treated and treatment usually works well.
  • Improving your physical symptoms and taking action will probably help make your mood better.

Anxiety and depression can be treated many ways, including medicine, psychotherapy, or both. These treatments can help a person feel better and improve the quality of their life. Please see Anxiety, Fear, and Depression to learn more about this.

Getting support

Support in any form allows you to talk about your feelings and develop coping skills. Studies have shown that many people who take part in support groups have a better quality of life, including better sleep and appetite.

A support group can be a powerful tool for both patients and families. Talking with others who are in situations like yours can help ease loneliness. Others who have had the same experiences may also share ideas that might help you. Contact your American Cancer Society to find out about sources of support in your area.

Types of support

You can find support programs in many different formats, such as one-on-one counseling, group counseling, and support groups.

Counseling. You may enjoy a personal connection with a counselor who can give you one-on-one attention and encouragement. It’s important to find a counselor who has had some training and experience in taking care of people with cancer. Your cancer care team is the best way to get names of counselors in your area. Another resource, the American Psychosocial Oncology Society (APOS), can connect you to a counselor, too. If you see a counselor and don’t feel comfortable or safe talking with that person, call APOS at 1-866-276-7443 and ask for other names. They also have a lot of useful information online at www.apos-society.org.

Support groups. Some support groups are formal and focus on learning about cancer or dealing with feelings. Others are informal and social. Some groups are made up only of people with cancer or only caregivers, while some include spouses, family members, or friends. Other groups focus on certain types of cancer or stages of disease. The length of time groups meet can range from a set number of weeks to an ongoing program. Some programs have closed membership and others are open to new, drop-in members.

It’s very important that you get information about any support group you’re thinking about joining to make sure that there are patients in all phases of treatment, including some with cancer that can’t be cured. Ask the group leader or facilitator to tell you what types of patients are in the group and if anyone in the group is dealing with cancer that doesn’t go away.

Online support groups may be another option. The Cancer Survivors Network, an online support community supported by your American Cancer Society, is just one example. (You can find it at csn.cancer.org.) There are many other reputable communities on the Internet that you can join, too.

“Having someone to talk to who knows exactly how I feel is great. The people in my group understand like no one else can.”
-Ed, living with follicular non-Hodgkin lymphoma

Religion and spirituality

Religion can be a source of strength for some people. Some find new faith during a cancer experience. Others find that cancer strengthens their existing faith or their faith provides newfound strength. If you are a religious person, a minister, rabbi, other leader of your faith, or a trained pastoral counselor can help you identify your spiritual needs and find spiritual support. Some members of the clergy are specially trained to help people with cancer and their families.

Spirituality is important to many people, even those who do not observe a traditional religion. Many people are comforted by recognizing that they are part of something greater than themselves, which can help them find meaning in life. The practice of forgiveness or performing small acts of kindness helps some people. Others meditate, spend time in nature, or practice gratitude – these are just a few of the many ways that people attend to their spiritual needs.

If it’s a struggle to find meaning in your life, or make peace with yourself, you may wish to spend time with a respected counselor or member of the clergy who can help you with this important work.

Family members, loved ones, and caregivers

You may worry about how your illness and care will affect your family and loved ones. This is a very tough journey to travel alone, and everyone needs help and support from those close to them. It can be hard to know how to start – who to talk to and what to say. You may want to read Telling Others About Your Cancer. If there are children in your family, you may also want to read Helping Children With Cancer in the Family: Dealing With Recurrence or Progressive Illness.

If you’re part of a couple, your partner may step up and offer to help you get back and forth to treatment, go with you to appointments, and help you deal with treatment side effects. Singles may need to find a friend or family member who can help in these ways. Whether it’s your spouse, partner, friend, or other relative, the person who helps you get your cancer treatments and manage side effects is called a caregiver. This is someone who wants to help and support you, but in order to do that they will need their own support and help. They can start by reading What It Takes to Be a Caregiver or call us for more information.

Paying for cancer treatment

Finances are often a very real concern for people with cancer. Treatment costs a lot. Hopefully, you have been able to keep your health insurance. Sometimes there are insurance options that people with cancer may not be aware of. Talk to your cancer care team, your facility’s financial counselors, or a social worker. You can also call us for help finding possible sources of financial assistance.

Some questions you may want to ask your cancer care team

  • How long do you think I can live with this cancer? What’s the range of survival times for people in my situation?
  • How will I know if the cancer is getting worse?
  • What do you think I should expect at this point?
  • What symptoms do I need to watch for and tell you about?
  • How often will I need treatment or need to see the doctor?
  • What’s the goal of treatment right now? Control of the cancer? Comfort?
  • What tests will I need to watch for changes in the cancer?
  • What can be done for symptoms I have (pain, fatigue, nausea, etc.)?
  • Are there any support groups I can go to?
  • How will I pay for treatment? Will my health insurance cover it?

Hope

Most people think of cancer as a disease that people get, have treated, and either are cured of or die from. When cancer is first found, the hope is for a cure. And for some people that hope is possible. But there are a lot of people who have cancer, are treated, and aren’t cured – they live with cancer.

If the cancer has already spread, the hope may be that the cancer can be stopped or slowed down. There’s hope for time, for being with loved ones, and finishing important tasks. Some people have cancer that can be controlled with treatment and they can live for a long time.

If treatment stops working, the hope may change again. It may be hope for time to prepare family and loved ones who will be left behind, for telling them what they have meant to you and what you hope for their futures. This can allow a deep closeness to the people you love.

There can also be hope for time to plan the end of your life – where you want to spend your last days and what you do and don’t want. This can ease the burden of uncertainty your loved ones may have about what to do and what you’d want. Your clear plans can be a very important gift to them and help them be at peace with the hard choices they may have to make when you can no longer say what you want.

Whatever your hope is, find the support and help you need to try and make it happen.

Cancer Prevention Diet

A healthy diet can help you prevent or fight cancer. Here’s how to lower your risk with cancer-fighting foods.

Some cancer risk factors, such as genetics and environment, are out of your control, but research suggest that about 70% of your lifetime risk of cancer is within your power to change, including your diet. Avoiding cigarettes, limiting alcohol, reaching a healthy weight, and getting regular exercise are all great steps for preventing cancer. Adopting a healthy diet can also play a vital role.

What you eat—and don’t eat—can have a powerful effect on your health, including your risk for cancer. While research tends to point to associations between specific foods and cancer, rather than solid cause-and-effect relationships, there are certain dietary habits that can have a major influence on your risk. For example, eating a traditional Mediterranean diet rich in fruit, vegetables, and healthy fats like olive oil can lower your risk for a variety of common cancers, including breast cancer. Conversely, a diet that includes a daily serving of processed meat increases your risk of colorectal cancer.

If you have a history of cancer in your family, making small changes to your diet and behaviors now can make a big difference to your long-term health. And if you’ve already been diagnosed with cancer, eating a nutritious diet can help support your mood and strengthen your body during this challenging time.

Simple ways to build your cancer-prevention diet

To lower your risk for many types of cancer—as well as other serious disease—aim to build your diet around a variety of antioxidant-rich fruit and vegetables, nuts, beans, whole grains, and healthy fats. At the same time, try to limit the amount of processed and fried foods, unhealthy fats, sugars and refined carbs you consume.

Lower your risk with antioxidants

Plant-based foods are rich in nutrients known as antioxidants that boost your immune system and help protect against cancer cells.

  • Diets high in fruit may lower the risk of stomach and lung cancer.
  • Eating vegetables containing carotenoids, such as carrots, Brussels sprouts, and squash, may reduce the risk of lung, mouth, pharynx, and larynx cancers.
  • Diets high in non-starchy vegetables, such as broccoli, spinach, and beans, may help protect against stomach and esophageal cancer.
  • Eating oranges, berries, peas, bell peppers, dark leafy greens and other foods high in vitamin C may also protect against esophageal cancer.
  • Foods high in lycopene, such as tomatoes, guava, and watermelon, may lower the risk of prostate cancer.

Add more fruit and veggies to your diet

Currently, most of us fall well short of the recommended daily minimum of five servings of fruit and vegetables. To add more to your diet, focus on adding “whole” foods, as close to their natural state as possible. For example, eat an unpeeled apple instead of drinking apple juice.

Breakfast: Add fresh fruit, seeds, and nuts to your whole grain, low-sugar breakfast cereal (such as oatmeal).

Lunch: Eat a salad filled with your favorite beans and peas or other combo of veggies. Add lettuce, tomato, and avocado to a whole grain sandwich. Have a side of carrots, sauerkraut, or fruit.

Snacks: Grab an apple or banana on your way out the door. Dip carrots, celery, cucumbers, jicama, and peppers in hummus. Keep trail mix made with nuts and dried fruit on hand.

Dinner: Add fresh or frozen veggies to your favorite pasta sauce or rice dish. Top a baked potato with broccoli, sautéed veggies, or salsa.

Dessert: Choose fruit instead of sugary desserts.

Fill up on fiber

Fiber, also called roughage or bulk, is found in fruit, vegetables, and whole grains and plays a key role in keeping your digestive system clean and healthy. It helps keep cancer-causing compounds moving through your digestive tract before they can create harm. Eating a diet high in fiber may help prevent colorectal cancer and other common digestive system cancers, including stomach, mouth, and pharynx.

Choose healthy fats

Eating a diet high in fat increases your risk for many types of cancer. But healthy types of fat may actually protect against cancer.

Avoid trans fat or partially hydrogenated oil found in packaged and fried foods such as cookies, crackers, cakes, muffins, pie crusts, pizza dough, French fries, fried chicken, and hard taco shells.

Limit saturated fat from red meat and dairy to no more than 10 % of your daily calories.

Add more unsaturated fats from fish, olive oil, nuts, and avocados. Omega-3 fatty acids found in salmon, tuna, and flaxseeds can fight inflammation and support brain and heart health.

Cut down on sugar and refined carbs

Consuming refined carbs that cause rapid spikes in blood sugar has been linked to an 88% greater risk of prostate cancer, as well as other serious health problems.

Instead of sugary soft drinks, sweetened cereals, white bread, pasta and processed foods like pizza, opt for unrefined whole grains like whole wheat or multigrain bread, brown rice, barley, quinoa, bran cereal, oatmeal, and non-starchy vegetables. It could lower your risk for colorectal and prostate cancer as well as help you reach a healthy weight.

Limit processed and red meat

Many different studies have established a link between the risk of cancer and eating processed meat such bacon, sausages, hotdogs, pepperoni, and salami. Eating about 2 oz. (50 grams) a day of processed meat increases your risk of colorectal cancer by 20%. This could be due to the nitrate preservatives or other substances used in the processing of the meat, although risk factors for cancer also increase by eating red meat, too. The safest strategy is to limit the amount of processed meat you consume and vary your diet by seeking out other protein sources, such as fish, chicken, eggs, nuts, and soy, rather than relying just on red meat.

Prepare your food in healthy ways

Choosing healthy food is not the only important factor in preventing cancer. It also matters how you prepare, store, and cook your food.

Boosting the cancer-fighting benefits of food

Here are a few tips that will help you get the most benefits from eating all those great cancer-fighting foods, such as fruit and vegetables:

Eat at least some raw fruits and vegetables as they tend to have the highest amounts of vitamins and minerals, although cooking some vegetables can make the vitamins more available for our body to use.

When cooking vegetables, steam only until tender. This preserves more of the vitamins. Overcooking vegetables removes many of the vitamins and minerals. If you do boil vegetables, use the cooking water in a soup or another dish to ensure you’re getting all the vitamins.

Wash all fruits and vegetables. Use a vegetable brush for washing. Washing does not eliminate all pesticide residue, but will reduce it.

Flavor food with immune-boosting herbs and spices. Garlic, ginger, and curry powder not only add flavor, but they add a cancer-fighting punch of valuable nutrients. Other good choices include turmeric, basil, rosemary, and coriander. Try using them in soups, salads, and casseroles.

Tips for cutting down on carcinogens

Carcinogens are cancer-causing substances found in food. They can form during the cooking or preserving process—mostly in relation to meat—and as foods starts to spoil. Examples of foods that have carcinogens are cured, dried, and preserved meats (e.g. bacon, sausage, beef jerky); burned or charred meats; smoked foods; and foods that have become moldy.

To reduce your exposure to carcinogens:

Do not cook oils on high heat. Low-heat cooking or baking (less than 240 degrees) prevents oils or fats from turning carcinogenic. Instead of deep-frying, pan-frying, and sautéing, opt for healthier methods such as baking, boiling, steaming, or broiling.

Go easy on the barbecue. Burning or charring meats creates carcinogenic substances. If you do choose to barbecue, don’t overcook the meat and be sure to cook at the proper temperature (not too hot).

Store oils in a cool dark place in airtight containers, as they quickly become rancid when exposed to heat, light, and air.

Avoid food that looks or smells moldy, as it likely contains aflatoxin, a strong carcinogen most commonly found on moldy peanuts. Nuts will stay fresh longer if kept in the refrigerator or freezer.

Be careful what you put in the microwave. Use waxed paper rather than plastic wrap to cover your food in the microwave. And always use microwave-safe containers.

The five worst foods to grill

  • Chicken breast, skinless, boneless, grilled, well done
  • Steak, grilled, well done
  • Pork, barbecued
  • Salmon, grilled with skin
  • Hamburger, grilled, well done

Source: Physicians Committee for Responsible Medicine

GMOs, pesticides, and cancer risk

Genetically modified organisms (GMOs) are plants or animals whose DNA has been altered in ways that cannot occur in nature or in traditional crossbreeding, most commonly in order to be resistant to pesticides or produce an insecticide. While the U.S. Food and Drug Administration (FDA) and the biotech companies that engineer GMOs insist they are safe, many food safety advocates point out that these products have undergone only short-term testing to determine their effects on humans.

Some animal studies have indicated that consuming GMOs may cause certain types of cancer. Since most GMOs are engineered for herbicide tolerance, the use of toxic herbicides like Roundup has substantially increased since GMOs were introduced. Some studies have indicated that the use of pesticides even at low doses can increase the risk of certain cancers, such as leukemia, lymphoma, brain tumors, breast cancer, and prostate cancer. However, research into the link between GMOs, pesticides, and cancer remains inconclusive.

If you’re worried about GMOs and pesticides, buy organic or local foods

In most countries, organic crops contain no GMOs and organic meat comes from animals raised on organic, GMO-free feed. Locally grown produce is less likely to have been treated with chemicals to prevent spoilage.

Other lifestyle tips for cancer prevention

While your diet is central to preventing cancer, other healthy habits can further lower your risk:

  1. Be as lean as possible without becoming underweight. . Weight gain, overweight and obesity increases the risk of a number of cancers, including bowel, breast, prostate, pancreatic, endometrial, kidney, gallbladder, esophageal, and ovarian cancers.
  2. Be physically active for at least 30 minutes every day. Physical activity decreases the risk of colon, endometrial, and postmenopausal breast cancer. Three 10-minute sessions work just as well, but the key is to find an activity you enjoy and make it a part of your daily life.
  3. Limit alcoholic drinks. Limit consumption to no more than two drinks a day for men and one a day for women.
  4. Where possible, aim to meet nutritional needs through diet alone, instead of trying to use supplements to protect against cancer.
  5. It is best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods. Babies who are breastfed are less likely to be overweight as children or adults.
  6. After treatment, cancer survivors should follow the recommendations for cancer prevention. Follow the recommendations for diet, healthy weight, and physical activity from your doctor or trained professional.

Source: World Cancer Research Fund International

Seven Steps to Prevent Cancer

Nearly 1,736,000 Americans will be diagnosed with cancer this year and more than 606,800 will die. However, research shows that up to 50% of cancer cases and about 50% of cancer deaths are preventable with the knowledge we have today. Prevention and early detection are more important than ever — and are proven, effective strategies to lower health care costs.

You make choices every day that affect your health. Follow our Seven Steps to Prevent Cancer to reduce your risk.

DON’T USE TOBACCO

The use of tobacco products has been linked to many types of cancer, including lung, colorectal, breast, throat, cervical, bladder, mouth and esophageal. It’s never too late to quit. About 90 percent of all lung cancer is related to smoking. Non-smokers who are exposed to secondhand smoke are also at risk for lung cancer and other respiratory conditions.

PROTECT YOUR SKIN FROM THE SUN

Skin cancer is the most common and most preventable cancer in the United States. More than 96,400 people are diagnosed with melanoma annually. Exposure to the sun’s ultraviolet radiation causes most skin cancer. Be sure to use adequate sun protection year-round. Never use indoor tanning beds.

EAT A HEALTHY DIET

Eat lots of fruits, vegetables, beans and whole grains. Limit red meat and cut out processed meats. For healthy recipe ideas, visit our blog. It is also important to limit alcohol consumption because alcohol can increase your risk for liver, colorectal and breast cancers. If you drink alcohol, have no more than two drinks a day if you are a man or one drink a day if you are a woman.

MAINTAIN A HEALTHY WEIGHT AND BE PHYSICALLY ACTIVE

Getting at least 30 minutes of physical activity each day can make a big difference in your general health and well-being. Inactivity and obesity have been linked to breast and colorectal cancer, and there is also some evidence of a link to lung and pancreatic cancer. Add exercise to your routine to reduce stress, increase energy, boost your immune system, control your weight and reduce your risk for cancer.

PRACTICE SAFE SEX AND AVOID RISKY BEHAVIORS

Many strains of the human papillomavirus, also known as HPV, are spread through skin to skin contact during vaginal, anal and oral sex. High-risk strains of HPV have increasingly been found to cause many types of cancer. The Hepatitis B virus (HBV) can also be spread from person to person through unprotected sex. It can cause long-term liver infections that can increase a person’s chance of developing liver cancer.

GET IMMUNIZED (HPV & HEPATITIS VACCINES)

Certain viruses have been linked to cancer, but are preventable through vaccination. Talk to your health care professional about the age recommendations for HPV vaccines. In the U.S., approximately one-third of liver cancers are linked to the hepatitis B virus (HBV) and hepatitis C virus (HCV). An HBV vaccination is available and is recommended for babies, older children who were not vaccinated earlier and adults who are at risk for HBV infection.

KNOW YOUR FAMILY MEDICAL HISTORY AND GET REGULAR CANCER SCREENINGS

Talk to your health care professional about cancer screening. Some tests can help detect cancer early, when treatment is more likely to be successful, and some can also detect precancerous conditions before they become cancer. While screening has been proven to save lives, screening guidelines aren’t always “one size fits all.”

We all know eating nutritious foods helps us feel better and be healthier. What you might not know is diet may be related to up to 50% of cancers.

The good news is that certain foods can actually help prevent and fight cancer. This guide helps you add each season’s most nutritious anti-cancer foods to your diet.

Explore: Our Cancer Center helps people fight cancer using the latest treatments.

Which foods fight and prevent cancer?

When it comes to cancer-fighting foods, you can’t beat the power of produce and plant-based foods. Certain fruits, vegetables, nuts, beans, oats, whole grains, spices and teas provide unique benefits not found in other foods. These benefits help reduce the risks of certain cancers and can even slow tumor growth and recurrence. Most of these plant-based foods provide plenty of other health benefits too.

Learn: Attend a cooking demonstration for cancer-fighting foods (PDF).

While it’s better to eat these foods whenever you can (versus not at all), you can go a step further. The best way to eat produce is when it’s in season. In-season produce:

  • Tastes better.
  • Is more nutritious due to good growing conditions.
  • Is often cheapest due to its abundance and more local production.
  • Is better for the environment, as it promotes more sustainable farming.

Remembering which cancer-fighting foods are in-season isn’t easy. This visual guide can help you plan a cancer-fighting diet that includes more of these foods year round.

How do plant-based foods fight cancer?

Produce and plant-based foods help you fight cancer in a number of ways. The best way to benefit from their cancer-fighting compounds is to eat whole foods, not supplements. While some foods are better cooked and some are better organic, what’s most important is eating healthier overall.

Tip: Foods linked in the tables below (like tomatoes) help you discover healthy new recipes.

Carotenoids

Carotenoids like beta-carotene (carrots), lycopene (tomatoes) and lutein (spinach) provide you with antioxidants. Antioxidants help protect your cells from damage that might turn them into cancer cells.

Apricots Tomatoes Mangos** Plums Nectarines* Papaya** Bell peppers Acorn squash Pumpkin* Beets Carrots
Spring
Summer
Fall
Winter

(*) indicates foods that are better to buy organic, due to higher average pesticide residue.
(**) indicates foods that are less important to buy organic due to lower average pesticide residue.

  • Cooked tomatoes are higher in lycopene. According to the AICR, a diet high in lycopene could prevent 11% of prostate cancer cases.

Greens

Leafy greens are a rich source of folate, which helps with DNA formation and, in some cases, DNA repair. Abnormalities in your DNA can turn normal cells into cancer cells.

Spinach Kale Arugula
Spring
Summer
Fall
Winter

Cruciferous Vegetables

Cruciferous vegetables (those with cross-shaped flowers) have multiple cancer-fighting benefits.

First, they contain sulforaphane, which can turn off certain carcinogens. Sulforaphane may also turn on the natural process of cell destruction, which can be key to preventing cancer.

Second, they contain indoles, which are effective at preventing and slowing hormone-receptive cancers, like breast cancer.

Broccoli Cauliflower** Bok choy Broccoli sprouts Turnips Brussels sprouts Cabbage** Arugula Kale
Spring
Summer
Fall
Winter

Beans, Legumes and Soy

Like cruciferous vegetables, beans help prevent and fight cancer in multiple ways. Beans contain cancer-fighting substances, like

  • Protease inhibitors, which may slow tumor growth.
  • Phytates, which may help prevent or slow certain cancers.
  • Manganese, which helps form an enzyme that protects cells from damage.
  • Kaempferol and quercetin, which have antioxidant and anti-inflammatory properties.

Beans are best eaten cooked to prevent proteins called lectins from irritating your stomach. Canned beans are slightly less nutritious but still good for you (though you’ll want to avoid cans with BPA).

Soy is best eaten organic to avoid GM plants. What you may have heard about soy’s danger with hormone-sensitive cancers is untrue. Numerous studies after 2009, including from the American Cancer Society, show soy to be safe with these cancers.

Black beans Chickpeas Kidney beans Lentils Pinto beans Soy
Spring
Summer
Fall
Winter

Oats, Whole Grains and More

Oats and whole grains are low glycemic index carbohydrates, which can be very healthy in appropriate portions. Low glycemic index foods avoid spikes in blood sugar that can lead your body to store more fat. Oats contain:

  • Manganese and B-vitamins.
  • Selenium, which is a mineral that helps the immune system fight cancer.
  • Beta-glucan, which bolsters the immune system.
  • Plant lignans, which help protect against hormone-sensitive cancers.
Barley Brown rice Bulgur Oats & oatmeal Quinoa Corn Potatoes* Sweet potatoes**
Spring
Summer
Fall
Winter

Seasonings

The way you season your food can have surprising benefits for fighting cancer. Certain seasonings, either fresh or dried, can reduce inflammation and provide antioxidants, both key parts of cancer prevention.

Turmeric Basil Oregano Dill Garlic Ginger Parsely Rosemary Thyme
Spring
Summer
Fall
Winter
  • Turmeric seasoning has seven separate mechanisms that fight cancer. Use it with black pepper to increase its availability to be absorbed by your body by 1000%.
  • When you crush or chop garlic, let it sit for 10 minutes before cooking to increase its benefits.

Healthy Oils

Certain oils are much healthier than others and can have cancer-fighting properties. Eat these foods and use these oils to cook your foods.

Avocado** Almonds Walnuts Olive oil Canola oil Flax oil Grapeseed oil
Spring
Summer
Fall
Winter
  • Many nuts are excellent sources of protein and healthy fats that actually lower your cholesterol.
  • Recent studies suggest walnuts may reduce the risk and recurrence of breast cancer.
  • Use olive oil for low-temperature cooking and salad dressings.

Foods with Other Cancer-Fighting Properties

Asparagus** Mushrooms Berries Watermelon Melons Apples* Citrus fruits Green tea
Spring
Summer
Fall
Winter
  • Berries contain anthocyanins that can help fight cancer cell proliferation.
  • Watermelon is another good source of lycopene alongside tomatoes.
  • Green and white teas contain EGCG that can help prevent tumors from recruiting blood vessels to help them grow.

Event

Attend a Cooking Demonstration

Changing your diet for the better is tough. Luckily, the expert chefs and dietitians at Loma Linda University Health put on a cooking demonstration for cancer-fighting foods (PDF). If you’d like to attend and start incorporating anti-cancer foods in your diet, call 1-877-558-6248 to register.

Published: July 2019. This article is published by Loma Linda University Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician.

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