Life Over Cancer Blog

Common diabetes drug, metformin, appears to reduce cancer risk

Metformin, a commonly prescribed drug for the treatment of type 2 diabetes, has been touted in several recent studies as having the potential to reduce the risk of cancer in people taking it to control their disease.

Metformin (Glucophage) helps control both insulin levels and the amount of glucose produced by the liver. It’s given to people with type 2 diabetes who have not been able to control the disease through lifestyle changes – diet and exercise.

Since type 2 diabetes affects millions of people and those numbers continue to rise – even among children and teenagers – there is a lot of scientific interest directed toward this population. It has been observed that those taking metformin to control their disease also seemed to have less risk for certain cancers.

Moreover, lab studies have shown an association between metformin and its ability to cause the death of cancer cells.

Mexican Fiesta!

Cinco de Mayo may be behind us, but Mexican food is always a welcome treat. Below are three Life Over Cancer-approved recipes for your next Fiesta!

White Sangria

Makes 1 large punch bowl

Ingredients:

 2 ½ cups water

1 small bunch fresh mint

6 cinnamon sticks

6 ½ cups white grape juice (or apple juice)

1 – 10 ounce bag  frozen peaches

1 – 10 ounce bag frozen mango

2 medium oranges, sliced crosswise

2 small lemons, sliced crosswise

3 cup sparkling non-alcoholic apple cider

12 ounces sparkling water

Mint leaves, to garnish (optional) 

Instructions:

1. Combine the water, mint leaves, and cinnamon in a small saucepan, and bring to a boil over medium heat. Reduce the heat and simmer for several minutes. Remove from the heat and allow to cool.
2. Once the mixture has cooled to room temperature, remove and discard the mint and cinnamon sticks. Transfer the remaining mixture to a large serving bowl.
3. Add the grape juice, peaches, mangoes, orange and lemon slices, sparkling apple cider, and sparkling water to the serving bowl. Mix well.  Garnish with fresh mint leaves, if desired. 

 

12-Year Study Shows Doubling of Life Expectancy

EVANSTON, IL – A 12-year study conducted by the Block Center for Integrative Cancer Treatment has shown a doubling of life expectancy for a group of 90 metastatic breast cancer patients. The results were published in the July/August issue of The Breast Journal. The women, diagnosed before 1998, participated in a comprehensive clinical program that combined conventional treatments—surgery, chemotherapy, and radiation—with individualized nutrition and supplementation, as well as fitness and mind-spirit regimens.

Through the 1990s, median survival reported in metastatic breast cancer research ranged on average from 12 to 24 months. Median survival for Block Center consecutive case series patients was 38 months, and their five- year survival was 27%, versus 17% for comparison patients. Published literature on populations with more favorable prognostic factors treated in conventional clinics showed median survivals of 20 to 23 months. 

Survival of metastatic breast cancer patients at the Block Center was approximately double that of comparison populations, and possibly even higher compared to several randomized trials published during this period. It would appear that the advantage relative to just conventional treatment alone stems from the individually- tailored nutritional, nutraceutical, exercise and psychosocial interventions in the Center’s program.

In addition to age and occurrence of relapses several other factors, not typically assessed in conventional settings, can impact survival in breast cancer patients, among them: body weight, psychosocial distress with elevated catecholamines, cortisol, inflammatory and oxidative mediators, diet and physical activity. Randomized trials of single-agent therapies or one-dimensional interventions appear inadequate to address this complexity, and there is a need for new clinical models to research and test whole systems interventions, such as the integrative care program at the Block Center.

"New cancer drugs are routinely approved for extending survival for 2 to 3 months,” said Dr. Keith I. Block, medical and scientific director of the Block Center. “There currently is no drug that has demonstrated the potential to double the life expectancy of metastatic breast cancer patients, as evidenced in these findings. These data are another compelling argument for conducting further research into an integrative treatment model for cancer.

“Our statistics were derived from our community-based patient population. While our group was comparable on major prognostic factors, we had a higher proportion of relapsed and younger patients (the median age at onset of metastasis was 46 years) than the comparison patients, which usually means a poorer prognosis. One would have expected worse survival rates, but that is the opposite of what we saw.”

“This is the first time that treatment outcomes using integrative cancer therapy for this disease have been documented,” Dr. Block said. “The survival times for our population were substantially higher than for patients who received conventional treatment alone.”

Dr. Azra Raza, Director of the Myelodysplatic Syndrome Center, St. Vincent’s Comprehensive Cancer Center, New York, characterized the Block Center’s comprehensive, integrative program as “superior….This evidence- based integrative approach should serve as a wake-up call for oncologists to overcome their obsession with treating cancer as an isolated target, but rather pay attention to the cancer patient whose own faculties need to be harnessed as agencies to win this war.”

Citation: Survival Impact of Integrative Cancer Care in Advanced Metastatic Breast Cancer, Block KI, Gyllenhaal C, Tripathy D, Freels S , Mead MN, Block PB, Steinmann WC, Robert A. Newman RA, & Shoham J. The Breast Journal, 2009, 15(4), pp 357-366.

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

 

Black Bean Brownies with Walnuts

These brownies are loaded with essential fatty acids, fiber, and protein that all work to control the release of sugar into the blood. These also are more fudge like consistency.

Ask Dr. Block: Chronomodulated Chemotherapy

What is chronomodulated chemotherapy and who should consider this approach to treatment?

There are nine specific "clock-related" genes in our brainstems that control our time-dependent biological functions, including sleeping and eating patterns, heart rate, body temperature, and hormone production. Similarly, cancer cells also have time controls; they divide and rest at different times of any given day. While rest and division also occur among healthy cells, their timing differs from that of cancer cells.

We can take advantage of this by administering the drugs at the specific time when cancer cells divide, and are more vulnerable to cell death, and when healthy cells are at rest, and least sensitive to toxicity from chemotherapy. Research demonstrates chronotherapy not only improves treatment tolerance, but can improve response and survival as well. In fact, the literature contains studies showing that chronomodulated chemotherapy can even allow for patients who previously needed to discontinue a chemotherapy protocol - either because it was ineffective, became ineffective prematurely, or was too debilitating to tolerate - and benefit from that identical drug protocol when it was administered via chronomodulated chemotherapy. 

Gold standard research supports the use of chronomodulated chemotherapy. For example, for metastatic colon cancer patients, studies show that administering chemotherapy at the optimal time can halve toxicity and double treatment response. For advanced metastatic ovarian cancer, a study in the journal Cancer reported that optimal timing of chemotherapy can reduce toxic side effects by 50 percent and quadruple five-year survival. This is a four-fold improvement! (Four times as many patients were alive at the five year mark). The same study demonstrated a 75 percent reduction in the need to cut the treatment dose! 

Chronotherapy at the Block Center
I brought this technology to the U.S. from Europe in the mid 1990s, hoping to improve treatment tolerance among my patients, ultimately enhancing the benefits we were seeing from the integrative approach to treatment we were already providing (In fact, studies suggest that 1/3 of patients discontinue chemotherapy treatment prematurely due to the debilitating physical and psychological consequences). 

At the Block Center, we were implementing nutritional strategies and supplement formulations that could help diminish the side effects of chemotherapy – and my research team and I were conducting ongoing studies – when I came across the chronobiology evidence that sleep and activity cycles along with the timing of drug infusions were all clock dependent. The extensive research that demonstrated decreased toxicity and improved survival with the use of chronotherapy persuaded me that we needed to bring this technology to our patients as soon as possible. 

At the Block Center, we administer chronotherapy using a portable, computerized pump, small enough to fit in a fanny pack. The infusion of the chemotherapy drug resembles a sine wave curve, it starts infusing quite slowly, and ratchets up in carefully programmed stages. It slowly increases to the middle point of the cycle where it peaks, meaning the drug will be infused at its highest rate, and then slowly ratchets back down in an exact mirror image to its ascending slope. When the drug dosage reaches zero, the cycle is complete.

Though there are currently over 40 major centers in Europe that participate in cooperative research using this method of chemo administration, there are less than a handful of clinics in the U.S. that implement it. Why is this? Currently, cancer treatment in our country is scheduled at the convenience of the hospital, medical center, treating physician, etc., not at the optimal time for the patient. In addition, the complexity of the technology would require training and incur additional expenses to the treating facility that would not be covered by insurance. 

However, the potential impact to reduce toxicity, improve response to treatment and even boost survival, makes the need to broaden access to this approach essential. Consider the fact that few if any drugs have improved survival by more than 18 weeks over the past two decades. Then realize that chronomodulating chemotherapy can improve outcomes in many studies by years. Thus, all patients deserve this no-risk/high-benefit approach to chemotherapy. It is my hope that one day chronomodulated chemotherapy will be widely available in this country, as it is outside the U.S.

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

Spaghetti Squash Sesame Noodles with Edamame

Spaghetti Squash is a great substitute for noodles and is an easy gluten free swap. Try it in the Asian-inspired recipe below.

Spaghetti Squash Sesame Noodles W/ Edamame

Ingredients:

Spaghetti Squash

2 tbsp Toasted Sesame Oil

2 tbsp Tamari Soy Sauce

1 tbsp Rice Wine Vinegar

pinch ground Ginger

pinch Garlic Powder

2 tbsp toasted Sesame Seeds

1/4 cup diced Green Onions

1/4 cup cooked & shelled Edamame

handful of fresh chopped Cilantro leaves

 

Instructions:

1. Cut spaghetti squash in half, long ways. Place both halves face down in a deep frying pan. Add abut an inch of water. Cover and steam the squash until fork tender.  Mix the dressing while steaming. 
2. Remove the squash and fork out the seeds to discard. Then begin to scrap the sides to remove the squash and place into a serving dish.
3. Combine sesame oil, tamari, vinegar, ginger, garlic powder and sesame seeds in a small bowl. Add optional hot sauce/Sriracha if desired.
4. Toss with spaghetti squash noodles. Gently fold in edamame and green onions at the end.

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

 

Soba Salad with Sesame-Ginger Seitan

Cashew Thai Quinoa Salad

 

Quinoa is a plant based super food that offers a complete protein source! Read on for a delicious and healthy recipe...

Ask Dr. Block: Tracking Progress

How do you track the progress of integrative cancer treatments at your center? What tests and measurements do you follow?

The primary tests that we use the standard medical assessments including, but not limited to, tumor markers, CT scans, PET-CT Scans and monitoring of physical symptoms. These are absolutely necessary to make sure your treatment plan is favorably impacting your disease.

We also provide some more innovative testing not generally part of a conventional workup. These are laboratory tests that assess your biochemical terrain by analyzing a number of terrain factors, such as inflammation, oxidation, glycemia, immunity, blood coagulation and stress hormones. The results provide our physicians and dietitians the information needed to individualize and personalize both a diet and supplement program to help create a cancer inhibitory environment. Terrain factors are reevaluated 2-3 times per year for patients with active cancers and recommendations are modified as needed.

We also provide an integrative lifestyle assessment. This is a series of questionnaires and in-office tests that evaluate lifestyle, diet, overall distress, body composition and parameters of physical activity, such as cardiac endurance, flexibility and strength. These assessments are regularly reviewed to provide support and counsel on an ongoing basis. Additionally, we perform comprehensive molecular tumor tissue analysis. Since cancer is a function of multiple gene related defects, this testing allows us the ability to select pharmaceutical and nutritional strategies to more precisely impact tumor targets affecting your disease.

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

Study: Global Effects of Sugar on Diabetes

As if we need another reason to stay away from sugar, an interesting one was recently provided by a team from California that includes Robert Lustig, a professor of clinical pediatrics at the University of California, San Francisco. Because this study concerns sugar and diabetes, it has an important message for cancer patients: type 2 diabetes is one of the major risk factors for getting cancer. In addition, we know that the nutritional processes involved in diabetes have implications for cancer patients.

Lustig and his colleagues assessed the relationship between sugar availability, obesity, economic development and diabetes prevalence in 175 countries around the world between 2000 and 2010; they also included data on several other food types, as well as variables like aging and urbanization. Rather than using data on individual patients, like clinical trials, they used data that applied to entire countries. For instance, the Food and Agriculture Organization has data on availability of sugar (including all types, sucrose, fructose and others), as well as things like fruit, meat or calories eaten per day. Other country-level data that the authors used included: how much of the population was obese or overweight, gross domestic product (a measure of overall economic development), and percentage of elderly people in the country. All these variables have previously been correlated to diabetes.

The study combined all the variables in a statistical model that allowed them to determine how much each of them contributed to diabetes prevalence in a country, which they obtained from the International Diabetes Federation. They checked on the data in several ways to make sure their results made sense. Here is some of what they found:

• Worldwide prevalence of diabetes increased by 27% from 2000 to 2010. That’s a frightening statistic if ever there was one!
• Sugar availability on its own accounted for a quarter of this increase. If a country experienced an increase of 150 calories per person per day in sugar availability (that’s the amount of sugar in a single can of soda!), its rate of people with diabetes increased by 1.1%. This was much more than any other food contributed to diabetes, and more than even total caloric consumption, which increased diabetes by only 0.1% with an increase of 150 calories per day per person of total food consumed.
• The other major contributors to increasing diabetes prevalence were obesity and gross domestic product. 

We know that obesity is related to diabetes, especially type 2 diabetes (this study does not distinguish type 1 from type 2 diabetes, but type 1 makes up only 10% of all diabetes). Gross domestic product is rather interesting: it’s a complex variable that impacts everything from the prevalence of desk jobs to dietary changes to stress. Every increase of 1% in gross domestic product resulted in a 1.07% increase in diabetes prevalence.

Some other interesting findings from the study confirm these major trends:

• In some countries, such as the Philippines, Sri Lanka and Bangladesh, diabetes rose rapidly but obesity did not. In these countries, it turned out, sugar availability rose by at least 20% in the 10 years surveyed in the study.
• The longer a country was exposed to high sugar availability (over 300 calories worth of sugar per person per day), the more its diabetes prevalence increased.
• If a country’s sugar availability decreased (usually due to changes in trade agreements) its diabetes prevalence decreased significantly.

The authors point out that changing the details in the variables used (for instance, adding alcohol or physical inactivity or smoking), did not change the sugar relationship to diabetes, and these variables did not make a statistically significant difference in diabetes prevalence. 

So what can we conclude from this study?

Mainly, we see that sugar consumption contributes much more to diabetes prevalence than we had thought. However, sugar consumption is not the only dietary concern when it comes to diabetes prevention – fiber intake, the consumption of healthy fats, and total caloric intake also play a role. (In addition, it should be noted that regular exercise can also help in the prevention of diabetes.) But if we were to select a single food to target for population-wide reduction or elimination, sugar looks like the one to go after!

If you are a cancer patient, it’s important to know that type 2 diabetes, and even pre-diabetes, can result in high insulin levels in your blood as well as high blood sugar levels. And elevated levels of insulin in the blood have been found to increase the risk of several cancers.

We know it isn’t easy to break long-standing dietary habits, but hopefully understanding the link between sugar and diabetes will help inspire you in your efforts to eliminate unhealthful sugars from your diet!

Reference: Basu et al. PLOS One.  2013; 8(2) e57873.