Dr Lily Tomas

blockmindlessΠολεοδομικά Έργα

16 Νοε 2013 (πριν από 3 χρόνια και 6 μήνες)

118 εμφανίσεις

Dr Lily Tomas

McGrath Foundation 2009

Aetiology

of Breast Cancer


Multifactorial


Genetics and Environment =
Epigenetics


Genetics and Nutrition =
Nutrigenomics


Mind/ Body/ Spirit Connection =
Psychoneuroimmunology



Psychoneuroendocrinology

Breast Cancer and the Immune
System


Where in the spectrum are you???



Past History Breast Cancer


Current Diagnosis Breast Cancer


Family History of Breast Cancer



Breast Cancer and the Immune
System


Where in the spectrum are you???



Disease Wellness



Breast Cancer



Integrative Medical Model

Surgery
Chemotherapy
Radiotherapy

Pharmaceuticals

Nutrients/Herbs

Conservative Interventions:
Psychological/
Dietary Manipulation/Patient Education

Integrative Management of Breast
Cancer

Integrative
Treatment
of Breast
Cancer

Exercise

Social/
Spiritual

V & M s

Chemo

Drugs

Radio

Sleep

Psycho
logical

Herbal

Environ.
Influences

Diet

Purpose
Passion,
Pleasure

Breast Cancer and CAM


A recent Australian survey of women with breast
cancer indicates that 87.5% women had used
complementary therapies in order to improve their
physical health (86.3%), emotional well
-
being (83.2%)
and to boost their immune system (68.8%) Support
groups and meditation were also commonly used
therapies.



Use of CAM by Australian women with breast cancer.
Kremser

T, Evans A, Moore A et al.

s.l
.

: Breast 2008;17(4):387
-
94.


Lifestyle factors and Immunity


Important endogenous and steroid hormones can
combine with various lifestyle factors (
low exercise,
excess weight, poor diet, poor sleep
etc) to heighten
the risk of many diseases, including cancer.


Obesity

is associated with
increased mortality from
all cancers

and there is an accumulating body of
evidence as to the mechanisms by which
obesity can
contribute to the carcinogenesis process.




Benson S,
Arck

PC, Tan S et al.

Effects of obesity on
neuroendocrine
, CV and
immune cell responses to acute psychological stress in premenopausal women.
s.l
.

:
Psychoneuroendocrinology

2009;34(2):181
-
9.



Fair AM, Montgomery K.

Energy balance, physical activity and cancer risk.
s.l
.

: Methods Mol
Biol

2009;472:57
-
88.


Stress and Immunity


There is a wealth of evidence demonstrating that
psychological stress can adversely affect the
development and progression of almost every known
disease.
Both acute and chronic stressful states produce
documentable changes in our innate and adaptive immune
responses, which are predominantly mediated via
neuroendocrine

mediators from the HPA (hypothalamic
-
pituitary
-
adrenal) axis and the sympathetic
-
adrenal axis
.


MR,
Irwen
.

Human PNI: 20 years of discovery.
s.l
.

: Brain
Behav

Immun

2008;22(2):129
-
39.


14.
Ziemssen

T, Kern S.

PNI
-
cross
-
talk between the
immune and nervous systems
.
s.l
.

: J
Neurol

2007;254
Suppl

2:II8
-
11.


Stress and Cancer


Chronic stress has been associated with increased
susceptibility of
individuals to
infectious diseases and
cancer.


Severe stressful events can increase the risk of
cancer by almost 12x and severely threatening life
events, by 15x.





Reiche

EM,
Nunes

SO, Morimoto HK.

Stress, depression, the immune system and cancer.
s.l
.

:
Lancet
Oncol

2004;5(10):617
-
25.



Reiche

EM, Morimoto HK,
Nunes

SM.

Stress and depression
-
induced immune dysfunction :
implications of the
devt

and progression of cancer.
s.l
.

:
Int

Rev Psychiatry 2005;17(6):515
-
27.



B, Leonard.

Stress, depression and the activation of the immune system.
s.l
.

: World J
Biol

Psychiatry
2000;1(1):17
-
25
.


Chen C, David A,
Nunnerly

H, al. e. Adverse Life Events and Breast Cancer: Case Control Study.
BMJ

1995;311(7019):1527
-
30.





Stress and Cancer



Chronic stress has also been linked with
worse outcomes
in many immune
-
related disorders, including
cancer
,
inflammatory and infectious diseases, indicating that the
effects of our mental state on our immune system are
directly and clinically relevant to disease expression.




Mawdsley

JE,
Rampton

DS.

Psychological stress in IBD: new
insights into pathogenic and therapeutic implications.
s.l
.

: Gut
2005;54(10):1481
-
91.



Maunder RG,
Levelstein

S.

The role of stress in the
devt

and
clinical course of IBD: epidemiological evidence.
s.l
.

:
Curr

Mol
Med 2008;8(4):247
-
52.



Raison CL, Miller AH.

The
neuroimmunology

of stress and
depression.
s.l
.

:
Semin

Clin

Neuropsychiatry 2001;6(4):277
-
94.



Mind
-
Body Medicine and Cancer


Various behavioural strategies, psychological and
psychopharmacotherapeutic

interventions that
enhance effective coping and reduce affective distress
show beneficial effects in many disease, including
cancer.


Reiche

EM, Morimoto HK,
Nunes

SM.

Stress and depression
-
induced immune dysfunction : implications of the
devt

and
progression of cancer.
s.l
.

:
Int

Rev Psychiatry 2005;17(6):515
-
27.


Psych intervention and health
outcomes
among women treated
for breast cancer : a review of stress pathways and biological
mediatore
.
NcGregor

BA,
Antoni

MH.

s.l
.

: Brain
Behav

Immun

2009;23(2):159
-
66.



Mindfulness
-
based Stress
Reduction


There have been many recent studies, including a
systematic review, which demonstrate the
efficacious potential of MBSR in the management
of
cancer, particularly breast and
prostate

.


Those with breast and prostate cancer not only
showed improvements in mood but also improved
cytokine parameters with a reduction in levels of
pro
-
inflammatory cytokines.


Patients with advanced cancer were shown to have
a 10% chance of regression of growth and a 50%
chance of greatly improved quality of life.





Mindfulness
-
based Stress
Reduction



MBSR as supportive therapy in cancer care : a SR.
Smith JE, Richardson J,
Hoffman C et al.

s.l
.

: J Adv
Nurs

2005;52(3):315
-
27.



Effect of MBSR on immune function, QOL and coping in women newly
-
diagnosed with early stage breast cancer.
Witek
-
Janusek

L, Albuquerque K,
Chroniak

KR et al.

s.l
.

: Brain
Behav

Immun

2008;22(6):969
-
81.



1 year pre
-
post intervention follow
-
up of psychological, immune, endocrine and
BP outcomes of MBSR in breast and prostate Ca outpatients.
Carlson LE,
Speca

M,
Faris

P et al.

s.l
.

: Brain
Behav

Immun

2007;21(8):1038
-
49.



MBSR in relation to QOL, mood, symptoms of stress and levels of
cortisol
,
DHEA and melatonin in breast and prostate cancer
outpots
.
Carlson LE,
Speca

M, Patel KD et al.

s.l
.

:
Psychoneuroendocrinology

2004;29(4):448
-
74.



MBSR in relation to QOL, mood, symptoms of stress and immune parameters
in breast and prostate cancer
outpts
.
Carlson LE,
Speca

M, Patel KD et al.

s.l
.

:
Psychosom

Med 2003'65(4):571
-
81.



Mindfulness meditation for oncology pts : a discussion and critical review.
Ott

MJ, Norris RL, Bauer
-
Wu SM.

s.l
.

:
Integr

Cancer
Ther

2006'5(2):98
-
108.


Meares

A. What can the cancer patient expect from intensive meditation?
Australian Family Physician

1980;9(5):322
-
5.



Hypnosis, Relaxation and Guided
Imagery


In
those with breast cancer, significant effects have been
found with respect to NK cell activity, mixed lymphocyte
responsiveness and the number of peripheral blood
lymphocytes when compared with
controls.


Thus
, there appears to be
a role for hypnotic guided
imagery as an adjuvant therapy to breast cancer
.




A review of the impact of hypnosis, relaxation, guided imagery and individual differences
on aspects of immunity and health.
JH,
Gruzelier
.

s.l
.

: Stress 2002;5(2):147
-
63.



Immunological responses of breast cancer pts to
behavioual

interventions.
Gruber BL,
Hersh

SP, Hall NR et al.

s.l
.

: Biofeedback Self
Regul

1993;18(1):1
-
22.



Immune
reponses

to guided imagery during breast cancer treatment.
Lengacher

CA,
Bennett MP, Gonzalez L et al.

s.l
.

:
Biol

Res
Nurs

2008;9(3):205
-
14.



The effect of hypnotic guided imagery on psychological well
-
being and immune function
in patients with prior breast cancer.
Bakke

AC,
Purtzer

MZ, Newton P.

s.l
.

: J
Psychosom

Res 2002;53(6):1131
-
7.



Cognitive
Behavioural

Therapy


Group CBT
training and
psychotherapy
for women
with breast cancer have also resulted in improved
immune parameters.


Attending group therapy may double survival time
and a self
-
perception of being strong can also
improve survival time.







A pilot RCT assessing the effects of autogenic training in early stage cancer pts in relation to psychological status and imm
une

system responses.
Hidderley

M, Holt M.

s.l
.

:
Eur

J
Oncol

Nurs

2004;8(1):61
-
5.



An exploratory study into the effects of group psychotherapy on CV and
immunoreactivity

to acute stress in breast ca pts.
vad

der

Pompe

G,
Antoni

MH,
Duivenvoorden

HJ et al.

s.l
.

:
Psychther

Psychosom

2001;70(6):307
-
18
.


Spiegel D, Bloom J, Kraemer H,
Gottheil

E. Effect of psychosocial treatment on survival of patients with metastatic breast
cancer.
Lancet

1989;2:888
-
891.


28. Hawks S, Hull M,
Thalman

R,
Richins

P. Review of spiritual health: definition, role, and intervention strategies in health
promotion.
American Journal of Health Promotion

1995;95:371
-
8.



Group Therapy


Group support activities can also address components
of spiritual health such as meaning and purpose in
life, self
-
awareness and connectedness with self, others
and a larger reality.


Combinations of diet, meditation, prayer and group
support are available at
specialised

centres


Ian
Gawler

(
www.gawler.org
)


Petrea

King (www.quest forlife.com.au)

Sleep


Good sleep is essential for physical and mental health.
There
is strong evidence demonstrating that inadequate
sleep is associated with a multitude of health problems,
including cognitive impairment, mood disorders,
parasitical infections, cardiovascular diseases and
compromised
immunity

such as cancer.




Imeri

L,
Opp

MR.

How (and why) the immune system makes us sleep.
s.l
.

: Nat Rev
Neurosci

2009;10(3):199
-
210.



CA, Smyth.

Evaluating sleep quality in older adults : the Pittsburgh Sleep Quality Index can be used to detect sleep
disturbances or deficits.
s.l
.

: Am J
Nurs

2008;108(5):42
-
50.



Meerlo

P,
Sgoifo

A,
Suchecki

D.

Restricted and disrupted sleep : effects on ANS function,
neuroendocrine

stress
systems and stress
responsitivity
.
s.l
.

: Sleep Med Rev 2008;12(3):197
-
210.



Novati

A, Roman V, Cetin T et al.

Chronically restricted sleep leads to depression
-
like changes in NT receptor
sensitivity and
neuroendocrine

stress reactivity in rats.
s.l
.

: Sleep 2008;31(11):1579
-
85.



Preston BT,
Capellini

I, McNamara P et al.

Parasit

resistance and the adaptive significance of sleep.
s.l
.

: BMC
Evol

Biol

2009;9:7.


Sleep


Melatonin
is our natural sleep hormone and it is known to
decrease with increasing age. Recent studies have shown
that
melatonin
has an immune
-
modulating
effect.


It stimulates
the production of NK cells and CD4+ cells and
inhibiting CD8+ cells. It also stimulates the production of
granulocytes and macrophages, as well as the release of
various cytokines from NK cells and T
-
helper lymphocytes.



Cardinali

DP,
Esquifino

AI,
Srinivasan

V et al.

Melatonin and the
immune system
in aging.
s.l
.

:
Neuroimmunomodulation

2008;15(4
-
6):272
-
8.




Sleep


Atypical time schedules such as shift
-
work has also been
associated with breast cancer, due to a circadian
disruption and to a nocturnal suppression in melatonin
production.


In
-
vitro studies show that melatonin can reduce the
invasiveness of breast cancer cells.


Thus, enhancement of the production of melatonin, or
melatonin itself, has the potential therapeutic value to
enhance immune function.



MC,
Spaggiari
.

Sleep medicine in occupational health.
s.l
.

: G Ital Med
Lav

Ergon

2008;30(3):276
-
9
.


Sanchez
-
Barcelo

E. Melatonin modulates
aromatase

activity in MCF
-
7 human breast cancer cells.
Int

J
Cancer

2006:274
-
278.



Exercise


There is a wealth of evidence supporting the beneficial effects of
exercise upon the immune
system.



NK cells have been found to be the most responsive immune cell to
acute exercise. Their sensitivity to physiological stress combined
with their important role in innate immune defences indicate that
these cells are one link between regular physical activity and general
health status.




Woods JA, Vieira VJ,
Keylock

KT.

Exercise, inflammation and innate immunity.
s.l
.

:
Immunol

Allergy
Clin

North Am
2009;29(2):381
-
93.



Schedlowski

M, Schmidt RE.

Stress and the immune system.
s.l
.

:
Naturwissenschaften

1996;83(5):214
-
20.



Kizaki T,
Takemasa

T, Sakurai T et al.

Adaptation of macrophages to exercise training improves innate immunity.
s.l
.

:
Biochem

Biophys

Res
Commun

2008;372(1):152
-
6.



Timmons BW,
Cieslak

T.

Human NK cell subsets and acute exercise : a brief review.
s.l
.

:
Exerc

Immunol

Rev
2008;14:8
-
23.



de Lima C,
Alves

LE,
Iagher

F et al.

Anaerobic exercise reduces
tumour

growth, cancer
cachexia

and increases
macrophage and lymphocyte response in Walker 256
tumour
-
bearing rats.
s.l
.

:
Eur

J
Appl

Physiol

2008;104(6):957
-
64.



Exercise


Anerobic

exercise in animal studies has been shown to increase
both innate and
adaptive
immune function, decreasing tumour
growth and cancer
cachexia
.


It is important to note, however, that exercise needs to be
performed in moderation. Multiple effects of over
-
training
resulting in impaired immune response have been documented in
the literature.



de Lima C,
Alves

LE,
Iagher

F et al.

Anaerobic exercise reduces
tumour

growth, cancer
cachexia

and
increases macrophage and lymphocyte response in Walker 256
tumour
-
bearing rats.
s.l
.

:
Eur

J
Appl

Physiol

2008;104(6):957
-
64
.


Bishop NC, Gleeson M.

Acute and chronic effects of exercise on markers of mucosal immunity.
s.l
.

: Front
Biosci

2009;14:4444
-
56.



West NP,
Pyne

DB, Kyd JM et al.

The effect of exercise on innate mucosal immunity.
s.l
.

: Br J Sports Med
2008 May 22 [
Epub

ahead of print].



Nieman

DC, Henson DA, McMahon M et al.

Beta
-
glucan
, immune function and URTI in athletes.
s.l
.

: Med
Sci

Sports
Exerc

2008;40(8):1463
-
71.



Close P,
Thielen

V, Bury T.

Mucosal immunity in elite athletes.
s.l
.

: Rev Med Liege 2003;58(9):548
-
53.



Physical therapies
-

Yoga


There have been
some
studies on the efficacy of yoga practice on the
immune system. Most have been focused on the breathing
disciplines within yoga, namely
Pranayama

and
Sudarshan

Kriya
,
that are both rhythmic breathing processes traditionally used to
reduce stress and improve the immune system.


Cancer
patients who were either undergoing or had completed their
conventional therapy also showed a significant increase in NK cells
at 12 and 24 weeks after practicing the above yogic breathing
techniques compared with controls.




Wellness
through a comprehensive yogic breathing program
-

a controlled pilot trial.
Kjellgren

A,
Bood

SA,
Axelsson

K et al.

s.l
.

: BMC Comp
Altern

Med 2007;7;43.


Effect
of rhythmic breathing (SK and P) on immune functions and tobacco addiction.
Kochupillai

V,
Kumar P, Singh D et al.

s.l
.

: Ann N Y
Acad

Sci

2005;1056:242
-
52.


Effects
of yoga on NK cell counts in early breast cancer pts undergoing conventional treatment.
Rao

RM,
Tellas

S,
Nagendra

HR et al.

s.l
.

: Med
Sci

Monit

2008;14(2):LE3
-
4.



Physical therapies
-

Massage


There are mixed results as to the benefits of
massage for immune enhancement. Two
studies
have noted increases in dopamine, serotonin, NK
cells and lymphocytes in women with breast
cancer after thrice weekly massage for 5 weeks.
Depression, anxiety and anger were also
significantly
reduced.



NK cells and lymphocytes increase in women with BC following massage
therapy.
Hernandez
-
Reif

M, Field T,
Ironson

G et al.

s.l
.

:
Int

J
Neurosci

2005;115(4):495
-
510.


BC
pts have improved immune and
neuroendocrine

functions following
massage therapy.
Hernandez
-
Reif

M,
Ironson

G, Field T et al.

s.l
.

: J
Psychosom

Res 2004;57(1):45
-
52
.


Physical therapies
-

Acupuncture


Acupuncture has been used for centuries to prevent and
treat various conditions and to simply maintain good
health.
In
addition to its known effects on the nervous
system, emerging evidence suggests that it may also
effectively modulate the innate immune system which
plays important roles in inflammation, pain,
metabolism, cell proliferation and apoptosis.



Acupuncture and immune modulation.
Cabioglu

MT, Cetin BE.

s.l
.

: Am J
Chin Med 2008;36(1):25
-
36.


Acupuncture
and innate immunity.
G,
Peng
.

s.l
.

: Zhen
Ci

Yan
Jiu

2008;33(1):49
-
52.


The
messengers from PNS to CNS: involvement of
neurotrophins

and cytokines
in the mechanisms of A.
J, Du.

s.l
.

: Zhen
Ci

Yan
Jiu

2008;33(1):37
-
40.


Environmental Influences


Today’s society is filled with novel environmental toxins
which may play a significant role in the development and
progression of many chronic diseases, including breast
cancer:


Xeno
-
oestrogens


Pesticides/chemicals


Heavy metals


Electromagnetic radiation


Sick building syndrome



Recent advances in research on RF fields and health : 2001
-
2203.
Krewski

D, Glickman BW,
Habash

RW et
al.

s.l
.

: J
Toxicol

Environ Health B
Crit

Rev 2007;10(4):287
-
318.


Worgroup

report : base stations and wireless networks RF exposures and health consequences.
Valberg

PA,
van Deventer TE,
Repacholi

MH.

s.l
.

: Environ Health
Perspect

2007;115(3):416
-
24.


EMF and health outcomes.
B, Knave.

s.l
.

: Ann
Acad

Med Singapore 2001;30(5):489
-
93.



Dietary Modulation


There is strong evidence regarding the pro
-
inflammatory effects of fast
-
“foods” that contain high
amounts of saturated fatty and trans
-
fatty acids,
refined carbohydrates with an high
glycaemic

index.


“Junk food”


Either junk or food

Foods to Avoid or
Minimise


Sugar


Cancers require sugar for survival, consuming 3
-
5 x glucose
compared with healthy cells. This, in turn, wastes energy
reserves.


High GI diets have been linked with increased breast cancer
rate in post
-
menopausal women.


Read labels


corn syrup, hydrogenated starch,
sorbitol
,
sorghum, dextrin, lactose, fructose,
galactose
…..


Limit all fruit juices

Navarro
Silvera

S, et al. Dietary carbohydrates and breast cancer risk.
International Journal of Cancer

2004;114(4):653
-
658.


Foods to Avoid or
Minimise


Animal fats


Fat tissue is a major source of
oestrogen

production in
post
-
menopausal women.


High fat diets may reduce the amount of
oestrogen

excreted in the
faeces
, thereby increasing circulating
oestrogens
.


High fat intake is linked to obesity, insulin resistance
and lower levels of SHBG, which potentiates
oestrogenic

effects.


Reducing fat intake may lower the risk of relapse in
women with early
-
stage breast cancer.




Chlebowski

R, Blackburn G, al e. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention

N
utrition
Study.
J
Natl

Cancer Inst

2006;98(24):1767
-
76.





Foods to Avoid or
Minimise


Processed foods, Preservatives,
Colourings
,
Nitrites, Nitrates, Plastics, Agrichemicals


Significantly higher levels (50
-
60%) of pesticides and
PCBs have been found in malignant breast tissue
compared with benign breast disease.



The Breast Cancer Prevention Group. Breast Cancer: Environmental
Factors.
The Lancet

1992;340:904.


Willett WC, et al. Dietary Fat and
Fiber

in Relation to Risk of Breast
Cancer: An Eight Year Follow
-
up".
JAMA

1992;268(15):2037
-
2044.


Foods to Avoid or
Minimise


Several foods either contain naturally
-
occurring hormones
(animal products) or have natural
oestrogenic

properties
(soy) that may stimulate
oestrogen

production in the body.


Added synthetic hormones (commercially packed meat,
poultry, dairy products) may also have
oestrogenic

effects.


Women who ate BBQ meat > 2x month had an increased
risk of developing breast cancer.


Xeno
-
oestrogens

(plastics) which are thought to leach large
amounts of polymers into food/drink contents with
possible carcinogenic effects.



Charcoal or Flame Broiled Meat Linked To Breast Cancer Risk. Annual
Meeting of the American Association for Cancer Research; 2000 April
3,2000.



Foods to
Maximise


Regular intake of
colourful

vegetables has been shown
to decrease the incidence of cancer by 40%.


In particular,
cruciferous
vegies

(broccoli,
brussel

sprouts,
bok

choy
, kale, turnips, cauliflower) contain I3C,
which pushes the breakdown of
oestrogen

into a cancer
preventing rather than promoting pathway.



Rock C, al. e.
J
Clin

Oncol

2005;23(27):6631
-
8.


Doyle C, et al. Nutrition and Physical Activity During and After Cancer
Treatment.
CA Cancer J
Clin

2006;56:323
-
353.


Rahman

K, Li Y,
Sarkar

F. Inactivation of
akt

and NF
-
kappaB

play
important roles during indole
-
3
-
carbinol
-
induced apoptosis in breast
cancer cells.
Nutrition and Cancer

2004;48(1):84
-
94.



Foods to
Maximise


100g fresh vegetable sprouts daily for just 2 weeks has clearly
been shown to protect against DNA damage in human blood
cells.


Fish high in omega
-
3 EFAs (sardines,
mackeral
, herring, salmon,
tuna),whey, eggs, nuts (brazil) may also confer protective
benefits.


Flaxseed has the potential to reduce
tumour

growth in patients
with breast cancer.




Gill C. The Effect of Cruciferous and Leguminous Sprouts on
Genotoxicity
, In
vitro and In vivo.
Cancer
Epidemiol
. Biomarkers
Prev

2004;13:1199
-
1205.


Thompson L, Chen J, Li T. Dietary flaxseed alters
tumor

biological markers in
postmenopausal breast cancer.
Clin

Cancer Res

2005;11(10):3828
-
35.


Foods to
Maximise


Onions and garlic can provide some protection
from a variety of cancers, including breast.


Maitake
, Shiitake and
Reishi

mushrooms can
increase NK cells and improve antibody
responses.


Coriolus

versicolor

(PSK)



Galeone

C, et al. Onion and garlic use and human cancer.
American Journal of
Clinical Nutrition

2006;84(5):1027
-
1032.


Diamond W, al e.
An alternative medicine definitive guide to cancer
. Tiburon,
California: Future Medicine Publishing, Inc., 1997.



Foods to
Maximise


Curcumin

(turmeric) also has
chemopreventative

effects
and can inhibit the growth of cancer cells and the
formation of breast cancer metastases in animal models.


Curcumin

has also been shown to reduce cell sensitivity
to radiation
-
induced DNA damage without affecting
DNA repair.



Curcumin

inhibits proliferation, invasion, angiogenesis and metastasis of different cancers through
interaction with multiple cell
signalling

proteins.
Kunnumakkara

AB,
Anand

O,
Aggarwal

BB.

s.l
.

:
Cancer
Lett

2008;269(2):199
-
225.


Curcumin

downregulates

the inflammatory cytokines CXCL1 and 2 in breast cancer cells via
NFkappaB
.
.
Bachmeier

BE,
Mohrenz

IV,
Mirisola

V et al.

s.l
.

: Carcinogenesis 2008;29(4):779
-
89.


Extended treatment with physiologic concentrations of dietary
phytochemicals

results in altered gene
expression, reduced growth and apoptosis of cancer cells.
Moiseeva

EP, Almeida GM, Jones GD et al.

s.l
.

:
Mol Cancer
Ther

2007;6(11):3071
-
9.



Foods to
Maximise


GLA (Gamma
-
linolenic

acid), Omega
-
6 EFA, can inhibit
the action of the cancer gene Her
-
2/
neu

which is
responsible for almost 30% all breast cancers.


Found in evening primrose oil,
blackcurrent

seed and
borage oil.


Digestive enzymes :
chymotrypsin

(animal sources),
papain

(papaya),
bromelain

(pineapple) have anti
-
inflammatory
and possibly anti
-
tumour

effects.




Javier A, Menendez, al e. Effect of
-
Linolenic

Acid on the Transcriptional
Activity of the Her
-
2/
neu

(erbB
-
2)
Oncogene
.
Journal of the National Cancer
Institute

2005;97(21):1611
-
1615.


Cichoke

A. The effect of systemic enzyme therapy on cancer cells and the
immune system.
Townsend Letter for Doctors and Patients

1995(
ov
):30
-
32.


Foods to
Maximise


Various
dietary anti
-
oxidants
have shown considerable
promise as effective agents for cancer prevention by
reducing oxidative stress which has been implicated in the
development of many diseases, including cancer. (1)


A low intake of
carotenoids
, through poor diet and/or
lack of vitamin supplementation, has been associated with
an increased risk of breast cancer. (3) (4) (5) (6) (7)


Lutein

is a
carotenoid

found particularly in
dark green
leafy vegetables and in egg yolks.

(8)


Thus far, it appears that these benefits are more
pronounced in postmenopausal women, particularly with
oestrogen

receptor positive
tumours
. (10)

Foods to
Maximise


Cancer chemoprevention through dietary anti
-
oxidants :
progree

and promise.
Khan N,
Afaq

F,
Mukhtar

H.

s.l
.

:
Antiox

Redox

Signal 2008;10(3):475
-
510.


Dietary
carotenoids

and risk of breast cancer in Chinese women.
Huang JP, Zhang M, Holman CD et
al.

s.l
.

: Asia Pac J
clin

Nutr

2007;16
Suppl

!:437
-
42.


Serum
carotenoids

and breast cancer.
Toniolo

P, Van
Kappel

AL,
Akhmedkhanov

A et al.

s.l
.

: Am J
Epidemiol
. 2001;153912):1142
-
7.


Prospective study of
carotenoids
,
tocopherols

and retinoid concentrations and the risk of breast cancer.
Sato r,
Helzlsouer

KJ,
Alberg

AJ et al.

s.l
.

: Cancer
epidemiol

Biomarkers Prev. 2002;11(5):451
-
7.


Breast cancer, serum antioxidant vitamins and p53 protein
overexpression
.
Kim MK, Park YG, Gong G
et al.

s.l
.

:
Nutr

Cancer. 200243(2):159
-
66.


Nutrition and Cancer: a review of the evidence for an anti
-
cancer diet.
MS, Donaldson.

s.l
.

:
Nutr

J.
2004;3:19.


Diet and cancer.
Divisi

D, Di
Tommaso

S,
Salvemeni

S et al.

s.l
.

:
Acta

Biomed 2006;77(2):118
-
23.


Lutein

and
zeaanthin

and their potential roles
indisease

prevention.
Ribaya
-
Mercado JD,
Blumbaerg

JB .

s.l
.

: J Am
Coll

Nutr

2004;23(6
Suppl
):567S
-
587S.


Puced

oxidative stress in women previously treated for breast
cancer.lasma

and dietary
carotenoids

are
associated with re.
Thomson CA,
Stendell
-
Hollis NR, Rock CL et al.

s.l
.

: cancer
Epidemiol

Biomarkers Prev. 2007;16(10):2008
-
15.



Fruits, vegetables and micronutrients in relation to breast cancer modified by menopause and hormone
receptor status.
Gaudet

MM, Britton JA,
Kabat

GC et al.

s.l
.

: Cancer
Epidemiol

Biomarkers Prev.
2004;13(9):1485
-
94.


Specific Dietary
Programmes


Gerson

Diet


Use of specific foods, juices, supplements and coffee enemas


Gawler

Foundation Diet


Raw, vegetarian food


Macrobiotic Diet


low fat, high
fibre
, mainly vegetarian diet
emphasising

whole grains and
vegetables and rich in
phyto
-
oestogens

from soy.




And so on………







Dietary Modulation


It is important to realise that any food, however, may
be pro
-
inflammatory for an individual who is
intolerant to that food.


Adverse reactions to foods can have a significant
impact on the immune system and general well
-
being
of an individual’s life.


Dietary Modulation


The simplest test to determine which foods contribute to
gastrointestinal or other symptoms is to perform a food
elimination diet (FED), with initial avoidance then
separate re
-
introduction of individual foods. Some of the
most common dietary intolerances are due to wheat,
dairy and soy.


Food intolerances can be associated with gastrointestinal
and , indeed, whole
-
body inflammation. This is
extremely important as
the gut (GALT) houses the
largest number of immune cells in the body (70%).




Overview of Gut immunology.
Mason KL,
Huffnagle

GB,
Noverr

MC et al.

s.l
.

: Adv Exp
Med
Biol

2008;635:1
-
14.


Dietary Beverages to
Maximise


EPG (Epigallocatechin
-
3
-
gallate), present in green tea, is
well
-
known for it’s ability to reduce the risk of a variety
of immunodeficiency disorders. Green tea possesses
anti
-
oxidant, anti
-
inflammatory, anti
-
carcinogenic
(breast) and immune enhancing properties.


Lime flower, peppermint and verbena teas may also
decrease cancer risk.






Immunostimulating

activity of a crude polysaccharide derived from green tea extract.
Monobe

M,
Ema

K, Kato F et
al.

s.l
.

: J Agric Food
Chem

2008;56(4):1423
-
7.


Zhang M, Holman C, al e. Green tea and the prevention of breast cancer: a case
-
control study in southeast
China.
Carcinogenesis

2006(Dec 20).



Hirvonen

T, Mennen L, al e. Consumption of antioxidant
-
rich beverages and risk for breast cancer in French
women.
Ann
Epidemiol

2006;16(7):503
-
8.




Dietary Beverages to
Maximise


Fresh juices, especially vegetable juice, are loaded with
cancer
-
fighting
phytochemicals
, enzymes, anti
-
oxidants and vitamins, in a state that is easily absorbed
by the body.


Wheatgrass,
spirulina

and other nutrients may be
added to the juices for extra benefit.



Dietary Beverages


Alcohol in light
-
moderate amounts (10g for women, 20g for
men) has been shown to be particularly beneficial for the
immune system when compared with both non and heavy
drinkers.


In particular,
Resveratrol
, a
polyphenol

from red wine, is able
to stimulate both innate and adaptive immune
responses.






Influence of alcohol consumption on
immumological

status : a review.
Diaz LE, Montero A, Gonzalez
-
Gross M et al.

s.l
.

:
Eur

J
Clin

Nutr

2002;56
Suppl

3
:S50
-
3.



Polyphenols

from red wine modulate immune responsiveness : biological and clinical significance.
Magrone

T,
Candore

G, Caruso C et al.

s.l
.

:
Curr

Pharm

Des 2008;14(26):2733
-
48.



Resveratrol

induces the heat
-
shock response and protects human cells from severe heat stress.
Putics

A,
Vegh

EM,
Csermely

P et al.

s.l
.

:
Antiox

Redox

Signal 2008;10(1):65
-
75.



Effects of
resveratrol

on human immune cell function.
Falchetti

R,
Fuggetta

MP,
Lanzilli

G et al.

s.l
.

: Life
Sci

2001;70(1):81
-
96.


Nutrition


Nutrition is a critical determinant of
immunity with
malnutrition being the
most common cause of
immunodeficiency worldwide
.

Nutrients either
enhance or depress immune function depending on the
nutrient and level of its intake.


Indeed
, both insufficient and excess nutrient intakes can
have negative consequences on immune status and
susceptibility to a variety of pathogens.



Nutrition
and the immune system : an introduction.
RK, Chandra.

s.l
.

: Am J
Clin

Nutr

1997;66(2):260S
-
63S.


Nutrition
and immunity with emphasis on infection and AI disease.
LS,
Harbige
.

s.l
.

:
Nutr

Health 1996;10(4):285
-
312.


Modulatory

effects of Se and Zn on the immune system.
Ferencik

M,
Ebringer

L.

s.l
.

: Folia
Microbiol

(
Praha
) 2003;48(3):417
-
26.



Nutrition


Available data indicates that Vitamins A, B6, B12, C, D, E, folic acid
and the trace elements Fe, Zn, Cu and Se all work synergistically to
support the protective activities of the immune cells. With the
exception of iron and Vitamin C, they are all also intricately
involved in antibody production.


Anti
-
oxidant vitamins and trace elements (Vitamins C, E, Se, Cu,
Zn) counteract damage to tissues secondary to oxidative stress
whilst simultaneously modulating immune cell function by
affecting the production of cytokines and prostaglandins.




Selected
vitamins and trace elements support immune function by strengthening epithelial barriers and
cellular and
humoral

immune responses.
Maggini

S,
Wintergerst

ES,
Beveridge

S et al.

s.l
.

: Br J
Nutr

2007;98
Suppl

1 :S28
-
35.


Contribution
of selected vitamins and trace elements to immune function.
Wintergerst

ES,
Maggini

S,
Hornig

DH.

s.l
.

: Ann
Nutr

Metab

2007;51(4):301
-
23.




Thankyou


Dr Lily Tomas

The Cottage

15
Merimbola

St
Pambula

(02) 64957300