The Gut Microbiome, Cancer And Immunotherapy - by Dr Lauren MacDonald

This week we have another insightful piece from Lauren, a 29 year old junior doctor when she was diagnosed with stage IV cancer, who is now celebrating one year NED. Here she discusses her obsession with gut health and why it is so important...

I thought I’d write another post on my favourite subject, “Gut Health”, but this time I’ve gone into the science behind why I’ve been banging on about the importance of looking after your gut microbiome for the past few years. I hope it’s helpful for anyone not yet up-to-speed on this fascinating area of research. 

Over the past few months several human studies have supported the idea that our intestinal bacteria (the gut microbiome) plays a significant role in determining whether cancer patients respond to certain treatments. In the latest research study, Dr. Wargo (a doctor and research scientist in the USA), revealed that the composition of a patient’s gut can significantly influence whether someone responds to the type of cancer immunotherapy I’ve been receiving for the past 22 months (pembrolizumab, an anti-PD1). Interestingly, what seemed to matter most in the studies wasn’t the level of a specific gut microbe, but rather the overall diversity of the gut microbiome. Let’s take a look at the evidence so far…

Where My Obsession With My Gut Health Began

Prior to 2015 I’d never considered the state of my gut microbiome. I hadn’t tried kefir, I didn’t take a regular probiotic and I’d never experienced the joys of eating Jerusalem artichokes (you’ll know what I mean if you’ve tried them!). Then in October 2015 I was diagnosed with stage IV melanoma, a cancer which is notoriously chemotherapy and radiotherapy resistant, and which previously had a 5-year survival rate of around 15%. Fortunately, a new immunotherapy drug was approved by the NHS at the beginning of 2016, just six weeks after I’d received the stage IV diagnosis. Although this was incredible news – and the idea of a “game-changing cancer drug” made for sensational headlines – it transpired that only a small group of patients had responded to the treatment during the clinical trials. The drug I was about to start had a response rate of around 30-40% (meaning patients had their tumours stabilise or shrink) with only 15% having a complete response (achieving no evidence of disease). I was determined to find myself in the latter group so I began researching how I could swing the odds in my favour.

My research began by examining the gut-brain axis, specifically the gut microbiome and its impact on health. I then looked at the way in which stress and anxiety could be impacting on my immune system. This lead me to further explore the growing field of psychoneuroimmunology and the research highlighting the value of mind-body therapies. It soon became apparent that there was a huge area of medicine that had been largely ignored during my medical degree. I felt relatively knowledgeable about “the mind” due to my Psychology degree and “the body” due to my medical degree, but there was a gap in my knowledge at the interface between the body and mind. I became fascinated by the gut-brain axis and, specifically, the impact the gut microbiome has on both mental and physical health.

Prior to becoming a stage IV patient, I’d already had four operations over the past 18 months in an attempt to “cure” me and prevent the cancer from spreading. Along with conventional surgery, I’d also addressed my diet, started juicing, added in supplements and began a regular yoga practice. But nothing seemed to be helping. The cancer kept coming back, again and again. Over Christmas 2015 I could visibly see new tumours growing above my right breast and a scan had already confirmed I had tumours in my lung and adrenal gland. Consequently I started looking for other ways in which I could support my body to either fight cancer cells directly or slow down/prevent angiogenesis (the formation of new blood vessels – which helps “feed” tumours).

The Initial Gut Microbiome And Immunotherapy Research (2015)

Shortly after I started looking at the the gut-brain axis I came across some research which had just been published by the University of Chicago (back in November 2015). They’d found that by introducing a particular strain of bacteria into the gut of mice with melanoma, they were able to boost the ability of the animal’s immune system to attack tumour cells. The combination of oral doses of “good bacteria” and infusions with anti-PD-L1 immunotherapy nearly abolished tumour growth. Around the same time another group of researchers compared the effects of bacterial transfer (via fecal transplant) against immunotherapy (anti-PD-L1). They found that introducing the bacteria was just as effective as treating mice with anti-PD-L1 alone – resulting in significantly slower tumor growth. Furthermore, combining the benefits associated with the “good bacteria” with anti-PD-L1 treatment dramatically improved tumour control.

Turning My Attention To My Gut Health Before Starting Immunotherapy

Given these two fascinating studies I decided to do everything I could to get my gut in the best possible shape before starting immunotherapy. During one of my appointments I mentioned the research to my Oncologist (and explained my intention to diversify my microbiome) but, understandably, he was hesitant to support my plan. The microbiome is, of course, inordinately complex – with trillions of bacteria working in tandem to produce multivariate responses. Although the research in the initial mouse studies had been promising, it might have been the case that altering the gut microbiome in humans would have a different outcome – an idea that has recently been supported by a study which found that certain chemotherapies used to treat colorectal cancer actually become toxic to patients in the presence of certain gut bacteria.

Despite my Oncologist’s reservations, I set about diversifying my gut bacteria in the hope that I might help to push myself into the “complete responder” group. Along with having a diverse microbiome, I knew it was also important to have the right cocktail of bacteria. I didn’t have much to go on – just those two initial mouse studies – so I purchased probiotics which contained the specific bacteria which had helped the mice to survive (Bifidobacterium – although the probiotic I took actually contained several other strains too). I also changed my diet to include as many pre- and probiotics as possible.

Key Diet Changes

I know I’ve shared lots of blog posts about this subject during the past two years, but just to remind you once again…

• The best way to keep your gut microbiome healthy is to make sure you’re getting a healthy mix of probiotics and prebiotics in your diet.
• Although taking a probiotic supplement is also helpful, there are plenty of studies that suggest oral probiotics struggle to make a huge difference to the microbiome (compared to the impact of fecal transplants).
• Simply changing our diets to include plenty of fibre, reducing refined sugars and not eating processed foods, can help improve the balance of bacteria in the gut.
• You can easily load up on probiotics by eating certain foods (e.g. sauerkraut, kefir, miso, apple cider vinegar, sourdough bread).
• Prebiotics are things like garlic, leeks, chicory root, Jerusalem artichokes, asparagus and under-ripe bananas.
• Research also suggests that omega-3 fats (found in oily fish) affect the microbiome in positive ways.
• It’s a great idea to try and fast for at least 12 hours overnight too. There’s lots of evidence to suggest this helps support a healthy gut microbiome.

The Latest Research (2017)

Dr Wargo teamed up with Gopalakrishnan and other researchers to collect faecal samples from more than 100 people with advanced melanoma before they began treatment with anti-PD-1 immunotherapy drugs. The scientists found that those who had the most diverse gut microbes were most likely to respond to the immunotherapy. The type of microbe was also linked to differences in responses to treatment. For example, people whose guts contained a lot of bacteria from a group called Clostridiales were more likely to respond to treatment. A second study showed that people who received antibiotics to treat infections shortly before or after starting immunotherapy did not respond as well to PD-1-blocking therapies. The researchers also found that the presence of the bacterium Akkermansia muciniphila was linked to better responses to immunotherapy. Responders had a far greater density of killer T cells – which are largely responsible for attacking cancer. The researchers found that the presence of the Faecalibacterium and Clostridiales bacteria seemed to account for the difference in T cell density. When these bacteria were given to cancer patients via a fecal matter transplant, they were more likely to respond to treatment and live longer without their tumour recurring or worsening.

The Microbiome: The Future Of Cancer Treatment?

I am under no illusion that the only reason I’m sitting here writing this post is because I’ve been on the receiving end of cutting-edge cancer treatment. I started immunotherapy in January 2016 and by August 2016 my scans revealed “no evidence of disease”. During the previous 10 months I’d become *OBSESSED* with looking after my gut but, of course, I have no way of knowing whether this made any difference to how I responded to immunotherapy. It might have been that I would have responded in exactly the same way, whether or not I’d changed my diet and started taking a daily probiotic supplement. Having said that, the 2015 studies and the new 2017 human studies suggest a big role for gut microbes in determining the cancer-killing potential of immunotherapies. Yet there are still plenty of questions, namely how, exactly, certain bacteria may help the immune system to fight cancer and if there are side-effects or potential dangers of manipulating the microbiomes of cancer patients. It will be fascinating to follow this research in the future. WATCH THIS SPACE!

I hope I’ve inspired you to look after your gut health – whether you are a fellow cancer patient or just someone looking to support their health and wellbeing.

Sending you lots of love and good health.

Lauren x

You can read more inspirational and informative posts on Lauren's blog, www.laurencara.com.

Please make sure you tell your own doctor before you start taking a daily probiotic – especially if you are undergoing cancer treatment. 

My journey with Black Salve - by Pauline Lomas

This week's blog is another from Pauline Lomas, author of And So We Heal, who beat breast cancer using no orthodox therapies and only non-invasion alternative therapies. Here she discusses her journey with Black Salve.

In 2004 whilst researching the next ‘holistic’ treatment option for the cancerous lump in my breast I came across Compound X, another name for ‘black salve’, also known as Cansema (see http://www.altcancer.com) Since I could not find any in the UK,  I ordered some from the USA with strict instructions on how to use it, and emphasis on the necessity to have good pain management and support in place.  I had read Ingrid Naiman’s wonderful book SALVES THAT HEAL, and felt prepared enough to go ahead. I was in Barcelona at the time – mid August, and sweltering (see page 156 of my book And So We heal.) Long story short – right choice – wrong timing!  The thick salve that I applied to the lump somehow melted in the heat and the result was extremely painful.  I decided then to abort the process but unfortunately I think I may have awoken the sleeping giant.  I had been trying to carry on as normal but the truth is if one is going to attempt this truly amazing treatment it is important to have support.

No regrets – that was 2004 and here we are 10 years later – I am still alive – minus one breast, but still on this long journey that has me passionate about helping to demystify the word cancer, and help herald better choices in the treatment of it.

After my ECT treatment in Malaga, Spain in 2005 I was able to get on with life. Sure I had lost most of the breast and all of my money and then some, but I was hoping that this was me done. Cancer Free – simple as that! The truth is after so many years of stringent living I was anxious to live a little. Abandoning my very strict regime, and rewarding myself with occasional treats, helped me to feel like a normal being; well as close as…..The task of committing myself to finishing a long planned book took it’s toll, and as each year passed and I missed the October ‘Breast cancer month’ deadline I would give in to stress.

By the time I finally published the book in 2009, I was exhausted and new tumour growth had invaded the chest wall.  Back to the drawing board then – My oncologist was keen to put me on Letrozole which I kept turning down – gut feelings always said no to that!

In retrospect – knowing what, and who I now know, my decision to have some surgical intervention in 2012 was a fear- based decision.  In all fairness to my oncologist, who has always been very supportive within NHS regulation, she did exactly as I had asked and left my lymph nodes intact.

Apparently the tumour had invaded the muscle so it took a fair while for my wound to heal. There was  a brief moment in time that all was well, or so I thought.  Since I had absolutely refused chemo and radiation I had to find further ways to support  my immune system with the hope of keeping further growth at bay.  The thing is – by this point research had advanced and I knew that there were other options available but I had no money….nature was my guide as always, and the seemingly never-ending journey continued…as one can see with the past blogs…

Then – as fate would have it a few weeks ago, I was introduced to Richard Linton, herbal pharmacist, www.greenwaynaturalpharmacy.com  and low and behold this wonderful soul has been working with the salve for more than 15 years.  Had I known this thirteen years ago when newly diagnosed and with one solitary lump, I may have had a chance at saving my breast.  My journey would be quite different as it happened.

Under Richard’s supervision I have embarked on yet another stage of healing, beginning with one prominent tumour that has been misbehaving.  The black salve was applied on August 6th and 2 weeks later the eschar that formed fell off.  I do have fotos which I will share at a later date.  Yes it was painful, especially the first week, but I had done my research and knew what to expect – sort of…

The good news is that I never needed pain killers and managed with homeopathic and herbal remedies, and of course my medicinal cannabis oil which is number one on my list.  Richard does not seem to be phased by the task at hand as we have quite a complex journey ahead, as we now attempt to draw the other lumpetybumps, as I like to call them through the opening left by the eschar…..I know, I know…….not easy to follow as I am hesitating actually showing fotos at this point so bear with me.  The drawing salve helps with this and is much gentler.

With the world in apparent turmoil everywhere I look, I am choosing to see it as a reflection of what’s happening in my own  body.  Yes – my chest is undergoing radical transformation – but so too the rest of me.  The aches and pains of a few months ago have gone and I am fitter in many ways than I was in my youth because of the natural food and holistic ‘medicines’ I choose to work with.  With todays emphasis on many of the failures of our health system surely it is only a matter of time before everything is privatised; so best get a jump start and stay in control of your own body as best you can.

Seeking to find the natural ways that feel instinctively right for me at this moment, I trust as always in the invisible helpers along the way.  Thank God that there are so many like-minded people doing much the same and by the graces we are drawn together to make things better.  Slowly but surely the portals seem to be opening wider and I am so grateful to still be alive and kicking and allowed access to this realm of magical living.

…………..And guess what – yesterday I arrived back from 2 days in Yorkshire where I had all my mercury fillings removed painlessly and holistically by yet another grand soul! More on that in the next blog…..with a bit of luck I can post this before September clicks in!  Keep the faith dear ones and leave no stone unturned…..YOUR HEALTH IS YOUR GREATEST TREASURE!

Supplements: Gimmick Or Good For You? - by Lauren MacDonald

This week's blog is another from Lauren MacDonald, a 29 year old junior doctor when she was diagnosed with stage IV cancer, who is now celebrating one year NED. Here she discusses her thoughts on supplements...

I was incredibly anxious when I was first diagnosed with cancer and was keen to exert some control back over the crazy world I’d found myself in. One of the first things I did involved going shopping for supplements. I figured that if there was anything I could buy over-the-counter to support my health, it was my duty to buy it. At one point I was taking over 25 different supplements everyday. That may sound excessive, but apparently increasing amounts of us are taking vitamin pills and herbal supplements with the aim of protecting ourselves against all manner of health problems. In the UK the market is currently worth £650m, with approximately 40% of us now popping a pill or two each day. The industry is phenomenally powerful, extremely lucrative and incredibly influential. But should we be taking all these supplements?

Gimmick or Good For You?

The supplement industry is divided into three groups: (1) vitamins; (2) minerals such as zinc, copper, selenium and iron; and (3) dietary supplements such as fish oils, herbs and spices. I went out and invested in various tablets and powders from across these different groups. This was despite my medical knowledge regarding how supplements are likely used by the body. From what I’ve been taught it seems that our bodies are not particularly efficient at digesting, processing, and absorbing supplements in pill form. When you take a pill it first travels to the stomach, where it breaks apart and releases the nutrients it contains. These are then absorbed and processed (usually by the liver), from where only a fraction of the nutrients then go on to enter into the bloodstream. Consequently it’s likely that plenty of supplements actually end up in your urine.

Another issue is that even if your body can absorb some of the nutrients, there is often limited scientific evidence available to support the use of many supplements. Having said that, this is often due to an absence of any proper scientific testing. In this situation all anyone can do is speculate about whether there are any benefits to be gained. Because of this, at the time of my diagnosis I was more than happy to buy my supplements under the caveat that “the scientific proof possibly just hasn’t been confirmed yet”. In my eyes being a guinea pig was far better than sitting back and doing nothing. Plus several friends offered up stories about their distant relatives/friends/neighbours who had cured their cancer by taking a concoction of supplements.

My Experience With Supplements

On reflection I’m sure that as a GP I wouldn’t have been overly enthusiastic about any of my patients taking 25 random pills every day. But back then, my rational “doctor voice” was drowned out by my petrified “patient voice”. I eventually got to a point where I couldn’t walk past a health food shop without diving in to buy the latest “cancer killing” or “immune boosting” supplement. My cupboards were full of spirulina powders to add to my juices, and chaga mushroom granules, dried cleavers, and pau d’arco to make up as teas. The supplements I was taking ranged from standard multivitamins and fish oils, to more unusual supplements like milk thistle, astragalus, and sea kelp. I was probably taking them regularly for about 6 months; right up until until the cancer came back.

Around the time I progressed to having stage 4 cancer (meaning that the cancer had spread to my chest from my leg), some new evidence was published which scared the bejesus out of me. Two studies had found evidence that taking supplements may actually increase the spread and severity of some cancers (specifically melanoma and lung cancer). Overnight my 20 supplements didn’t seem so “life saving”. Obviously this research was only preliminary, but it was enough to make me consider that maybe I shouldn’t be taking quite so many supplements, especially without having mentioned them to my oncologist.

Do You Need Supplements?

If I’m truly honest, I’m really unsure. From the research I’ve read it would seem that the answer is no. The problem is that it’s almost too easy to get your hands on supplements. These days there is a pill available for absolutely anything. Whether you have trouble sleeping, want to lose weight or get more of a certain vitamin into your body, there is a wide range of aids to choose from. Recently several studies have taken place to attempt to justify the use of vitamin and mineral supplements but the majority of them have come to the same conclusion – there is no concrete evidence to suggest that dietary and nutritional supplements have any real positive impact on health. Scientifically speaking there are no miraculous supplements that will help you find solutions to multifaceted health problems – especially not cancer. But it’s easy to fall for marketing promises and personal success stories.

Luckily it’s pretty easy to get everything you need just by eating a balanced, healthy diet and going outside every once in a while. Other than perhaps vitamin D, you don’t actually need to load up on extra amounts of these compounds. And in some cases you can actually overdose. For example, excess vitamin A in the body can cause blurred vision, dizziness and bone softening. However, there are some instances when certain supplements become necessary. For example, very strict vegetarians may need supplementary vitamin B12, and those who are pregnant or breastfeeding should consider vitamin D and folic acid.

My New List:

Two years ago, along with adding in a huge amount of supplements, I also gave my diet an overhaul. Although I have relaxed a little, I still eat a largely plant based diet and it is mainly through food that I now nourish my body – not supplements. My diet now includes more specific food items, such as, nuts and seeds, pomegranates, shiitake mushrooms, fermented foods, fresh turmeric, bee pollen, watercress, parsley, green tea and a whole host of other random bits and bobs which potentially have “immune boosting” or “cancer fighting” properties. Although I haven’t completely stopped all supplements, I am weary of taking too many. I am having regular infusions of Pembrolizumab (immunotherapy) and the last thing I want to do is cause any interactions, or prevent my wonder drug from doing it’s thing.

So…. what made my list?

(1) Vitamin D

Vitamin D helps to control the amount of calcium and phosphate in our bodies. Both are needed for healthy bones, teeth and muscles. Very few foods contain vitamin D (and those that do, such as milk and orange juice, are fortified). We tend to get most of our vitamin D from sun exposure, but in winter this can be problematic.

(2) Omega-3

Omega 3 helps protect against diabetes, heart disease and stroke, as well as providing support for brain health and memory. Found in oily fish such as salmon and tuna, many of us are deficient in omega 3 as we just don’t eat enough in our diet.

(3) Probiotics

I have an entire blog post dedicated to my love of probiotics and gut health in general. I cannot rave about them enough! Take a look at the post here.

(4) B Vitamins

B12 is an essential nutrient needed for nearly every bodily function and energy production. Low levels can cause damage to the nervous system and some of the early signs of deficiency are chronic fatigue, moodiness, and even dementia-like traits. Because the body cannot produce it on its own and it’s also scarce in our food system, it is advised for those with low levels to take a B12 supplement.

And that’s it.

From 25 supplements down to 4. It may seem simple but there it is. If you are taking care of yourself and eating a healthy balanced diet then if you ask me, these are the only supplements you should consider. Having said that, although I’m a qualified doctor, I’ll be the first one to put my hands up and admit we didn’t learn a huge deal about nutrition during our medical degree. To be honest I feel like I’ve taught myself a great deal more about nutrition and supplements since I was diagnosed with cancer. Because of this, I’d just like to highlight that the above information is my opinion only, and does not necessarily represent that of the wider medical community. I’d love to hear from any registered nutritionists or dieticians if you feel that I’m way off the mark with my opinion on supplements. I’m open to learning new things!

Lauren x

Please remember that it’s always advisable to seek professional advice before taking supplements anyway. Speak to your GP before you introduce anything new, especially if you take regular medication.

You can read more inspirational and informative posts on Lauren's blog www.laurencara.com.

Is There A Role For Diet In Cancer Treatment? My Opinion And Personal Experience - by Lauren MacDonald

Following the popularity of her previous blog, we have another post from Lauren MacDonald, a 29 year old junior doctor when she was diagnosed with stage IV cancer who is now celebrating one year NED. Here she discusses the role of diet in cancer treatment from her own personal experience.

Over the past few years I’ve received countless emails from people asking exactly what diet changes I’ve made since I was first diagnosed with cancer (in Feb 2014). Although it’s true that I’ve made certain changes, I’m always a little cautious about sharing them, mainly in case people think that because I’m a doctor that must mean the specific changes I’ve made are based on overwhelming scientific evidence. Although I’ve researched “cancer and nutrition” in detail, trawling through countless medical journals and review papers, I’m still not an expert in this field or a qualified nutritionist. Additionally, from what I’ve come across, there is still very little scientific evidence supporting the use of specific diets in cancer treatment anyway. The changes I’ve made to my diet have largely been in an attempt to nourish my body as much as possible, boost my immune system, and (*potentially*) help my body to fight cancer cells.

The Problem With Extreme “Cancer Diets”

Don’t get me wrong, for a little while right at the beginning, I definitely did get sucked into the idea that certain foods or diets might be able to rid me of cancer. I was guilty of dabbling with a few questionable/ridiculous diets (anyone for ground flaxseeds mixed with cottage cheese??!) but fortunately it wasn’t long before the medic inside of me woke up and put a stop to my nonsense. Yet the fact that I was sucked in at all shows just how easy it is for common sense to go AWOL when faced with cancer. For most cancer patients, changing their diet is as much a mental process as a physical act. It enables you to feel like you’ve got some control over a petrifying situation and I know I also felt comforted by the idea that nature might, just might, “cure all” (rather than toxic chemotherapy or other drugs).

Additionally there’s simply so much information available on the internet about “diet and cancer” that it’s almost impossible to avoid it as a newly diagnosed patient (who can often be found googling “cancer cures” at 2am). Without randomised controlled trials in this area (of which there have been very few – although I’m currently awaiting the results of an interesting one looking at watercress) it is difficult to separate fact from fiction. Ultimately, this can leave us patients, our friends and our families confused and vulnerable to inaccurate (and sometimes downright dangerous) information.

Cancer And Certain Diet Myths

The alkaline diet is one of the most popular “anti-cancer” diets. Fans of this diet believe that an acid diet encourages cancer formation, and that an alkaline diet is therefore the solution. The reason that acidity is seen as an issue is because while healthy cells get the majority of their energy from oxygen respiration, cancerous cells tend to inefficiently use glucose at a higher rate than healthy cells. This consumption of glucose results in acidic waste products, and consequently a higher acidity around cells which use this mechanism. BUT… THE FACT IS THIS: acidity is a consequence of the cancer rather than the cause. Therefore, an alkaline diet CANNOT affect cancerous cells. This is because tissue acidity is tightly regulated by our incredibly clever bodies (because otherwise we would die) and this cannot be altered simply by changing the food you put into your mouth.

Another anti-cancer diet I’ve seen tooted time and time again is the “no sugar diet“. Although there’s an established link between being obese or overweight and developing certain types of cancer, the suggestion that sugar “feeds” cancer is an over-simplification of some complicated biology. Yes it’s true that glucose is a sugar, but it is one required by every cell in the body to function, whether cancerous or not. Ultimately all carbohydrates, whether from vegetables or chocolate, are broken down to glucose for the body to then utilise for energy. The reason that the “no sugar diet” has become so popular is because cancer cells require sugars to grow – and their glucose intake is a lot higher than that of healthy cells (this is known at the Warburg effect). The hyperactive glucose consumption of cancerous cells results in a vicious cycle of continued stimulation of cancer development. However, all the cells in the body require “sugar” to survive so it’s impossible to rid yourself of glucose, no matter what you eat. There’s also no evidence that proves eating a low-sugar diet cures cancer.

The final diet which has limited evidence for curing cancer is the ketogenic diet. The ketogenic diet is a high fat, low carbohydrate, and typically a protein-restricted diet. Normally what we eat is composed of macronutrients: carbohydrates, proteins, and fats. The carbohydrates are things like bread, pasta, cakes and some of the fruits and vegetables that we commonly eat. Protein is found mainly in meat and dairy products. High-fat foods are things like bacon, peanut butter, creams, avocados, coconut milk etc. The average diet is about 50-75% carbohydrates and, thus, this is the energy currency that our bodies use. Contrasting with this, in a ketogenic diet about 90% of what a person eats is fat. There is very little protein and almost no carbohydrates. This simulates a fasting state in the body where instead of carbohydrates being used, the body uses ketones for energy. Some people claim this altered state can starve cancer, yet, there is very little evidence to support this idea (except perhaps for patients with brain tumours but, once again, the evidence is limited). There is some evidence, however, that a ketogenic diet can reduce inflammation in the brain and can help treat strokes and other neurological conditions like epilepsy. Among theories about the mechanism behind the ketogenic diet is that the mix of high-fat, low carbohydrates, and reduced protein intake may reduce firing of excitatory brain cells that can make the brain vulnerable to seizures. Unfortunately implementing this diet is a huge undertaking. It can incredibly challenging (and a little disgusting) to force such high fat foods into your body on a daily basis. I know my brother and his girlfriend tried the ketogenic diet as part of a study during her degree (Nutrition BSc) and they couldn’t maintain it for more than a few weeks.

How I Changed My Diet After My Diagnosis

During the first 12 months after I was diagnosed I went ALL OUT with my diet. I stopped eating anything sweet (chocolate, cakes, ice cream etc), juiced as though my life depended on it (daily – if not twice a day – so at least I got my moneys worth from my ridiculously expensive masticating juicer – it’s an Omega Vert in case you were wondering), added ground flaxseeds to everything, nibbled on raw garlic, made myself eat shiitake mushrooms with nearly every evening meal (despite not liking the texture), and washed all these foods down with gallons of green tea and chaga mushroom coffee. Then the cancer returned, making me a stage IV cancer patient, and I figured my mostly plant-based, highly restrictive diet wasn’t eliminating cancer cells and also wasn’t making my life that much fun. To add insult to injury I was also spending a fortune on my “anti-cancer diet”.

Given that my experiment didn’t “cure” me of cancer, I eventually relaxed my diet and simply integrated a few of my new healthy habits into my daily life. Fortunately, somewhere along the way (about four months after starting immunotherapy), I slowly began to journey from a stage IV cancer patient with aggressive tumours that kept popping up in various parts of my body, to someone with No Evidence of Disease.

What I Eat Now

I’ve pretty much reverted to eating exactly like I did before I got cancer. If I fancy a pizza, I have a pizza; if I fancy a bowl of ice cream, I eat the ice cream; if I fancy wine, I’ll have (red) wine (which apparently has anti-cancer properties anyway). Having said that, I now let myself be guided by what my body wants (I guess thats what people call “intuitive eating“) and my body invariably wants to be fed healthy, nourishing foods. The things I make sure to eat include:

Leafy Greens

Isothiocyanates (ITCs) found in leafy greens have been reported to help the body at a cellular level. The main ones I’ve added in to my diet (pretty much every day in a green juice) are kale, spinach and watercress. In addition to isothiocyanates, cruciferous veggies like broccoli also contain sulforaphanes and indoles – two types of antioxidants that protect the structure of DNA. The evidence is so strong that a pharmaceutical company in the UK, Evgen Pharma, is now designing drugs using sulforaphane. The drugs have been shown to kill cancer cells and improve the prospects of stroke patients.

Berries

Most mornings I have a handful of blueberries, raspberries, strawberries and pomegranate seeds, mixed with a spoonful of greek yogurt, a drizzle of almond butter and some mixed seeds. The ORAC scores of nearly all berries are very high, making them some of the best antioxidant foods.

Orange Foods

I make sure I eat plenty of carrots and sweet potatoes (carrots in my daily juices and sweet potatoes as wedges). This is because there’s some evidence that the beta-carotene found in orange foods is an essential nutrient for immune functioning, and given that I’m on an immune-boosting drug, it seems logical to try and give my immune system a helping hand with these foods.

Mushrooms

Several studies have linked higher mushroom intake to a reduced risk of breast cancer in premenopausal women. It has also been proposed that various mushrooms, such as shiitake, chaga, turkeys take and lion’s mane, may also help fight cancer. However, there is still no conclusive evidence that any type of mushroom can prevent or cure cancer.

Spices

The jury is still out on whether turmeric and ginger are “potent anti-cancer foods” but I still add them to all my juices. Make sure you add some black pepper to help with turmeric absorption.

Fermented Foods

Gut health! My favourite subject 🙂 Most of my blog posts seem to have been dedicated to this subject so I won’t go into too much detail here. The main foods I’ve kept in my diet are sauerkraut, kefir, apple cider vinegar, and cultured yoghurt. I try and have at least two of these foods everyday.

Nuts/Seeds

Have you tasted Pip and Nut’s Almond Butter? Not only is it pretty much the most delicious thing you will ever taste, it’s also a great source of protein, fibre and healthy fats. I also try to make sure I have a few brazil nuts every day as they are a great source of selenium.

Udo’s Choice Oil

I try to add a few tablespoons of this oil into my food at some point during the day (either on my breakfast, drizzled on salads or simply neat if I’ve forgotten to add it to a meal – it doesn’t taste too bad). This oil has the ideal ratio of Omega-3:Omega-6’s. I also try to get plenty of Omega’s by eating oily fish a few times a week. Omega-3 fatty acids exert anti-inflammatory effects and might help the body to fight cancer.

Matcha Green Tea

Matcha contains the highest percetange of polyphenolic compounds (catechin, gallocatechin and EGCG). EGCG has been reported to be linked to the modulation of multiple signaling pathways, finally resulting in the downregulation of expression of proteins involved in the invasiveness of cancer cells. It’s an acquired taste but I’ve grown to love it. Pukka Teas do a mild version that comes in teabags if you can’t handle the intensity of the powdered form.

The Take Home Message

I know this is really boring and not what you want to hear, but there really isn’t any one diet or food that will “cure” cancer. If there is (and I’m yet to come across it in my research) please, please let me know…

Using nutrition to support cancer treatment basically boils down to the age-old adage of eating a well balanced diet, enjoying your food, and not eating too much junk. The reality is that cancer is complex illness, and simple “cures” shared online should be treated with scepticism. Having said that, I truly believe that eating healthily has a role in cancer treatment – I just don’t think it will provide the sole “cure”. Personally I didn’t ever receive any diet advice from my healthcare team during my “cancer journey” and apparently this is not uncommon. This lack of nutritional advice for cancer patients in the UK needs to be addressed. In my opinion, we need a holistic approach to treating cancer and nutrition (along with exercise and stress reduction techniques) should be as much a part of cancer treatment as medicine and surgery.

I hope that this info helps anyone who is currently going through cancer treatment or just wants to live a healthier life. Remember, I’m not an expert in this field – these are just diet changes that felt right for me.

Organisations like Cancer Research UK have patient guides that are worth checking out for reliable information. Unfortunately, they aren’t as sexy as those offered up by online “wellness gurus” – but at least you know they’re based on real facts rather than far-fetched theories.

You can read more inspirational and informative posts on Lauren's blog www.laurencara.com.

Cancer and cell selectivity - by Dr Peter Damian Koeppel

Today's blog is written by Dr Peter Damian Koeppel who Robin interviewed on the on UK Health Radio, along with Rachel Hoyle and Rob Verkerk, a while back. You can listen to this here. He writes about how nucleotides can support people with cancer. 

Dr Koeppel has a PhD in Biochemistry and Immunology and was trained in Biochemistry (with a special interest in clinical immunology) at the University of Zürich’s Institute of Virology.

Nucleotides are the basic molecules of the DNA and RNA. The DNA of each cell contains the whole information of the body and must be correctly doubled before the cell is able to proliferate. This DNA multiplication and therefore also the cell proliferation is fully dependent on the availability of sufficient nucleotides. The normal cells of the body are capable to produce the needed amount of nucleotides by de novo synthesis. Additionally the normal body cells also absorb nucleotides from the blood circulation by the salvage pathway.

The cells of the immune system, like bone marrow cells, lymphocytes, macrophages as well as NK-cells are not able to produce nucleotides by themselves and are fully dependant on an outside supply of nucleotides either by the liver or by the food. Any external supply of nucleotides will therefore support a strong immune response.

                                                                                                                            

Nucleotides are present in higher amounts in human breast milk, and their uptake enhances a number of immunological as well non immunological functions in young children. It is clear that nature supplies these nucleotides in breast milk for positive development of the body. This would not be the case should nucleotides have a negative effect on the body.

Nucleotide Nutrition Ltd is the supplier of the Swiss Pro Bio AG pioneering line of nutritional additives based on purified RNA and nucleotides, Nutri-tide^®. These nucleotides can be used by the body for an increased cell multiplication. The additives are mainly designed to support the immune system and a good development of the gastro-intestinal tract.

People would think that potentially carcinogenic cells could also profit from the additional supply of nucleotides for their faster development. But, the body is equipped with some mechanisms to avoid this from happening.

1.             The rate of uptake of nucleotides is dependent on the state of differentiation of the cancer cells, e.g. Caco-2 cells, and the uptake by undifferentiated cells is less efficient than that by differentiated cells. (Ian R. Sanderson and Youping He; The journal of nutrition, Vol.124, January 1994)

Therefore the supply of nucleotides gives more support to an optimal function of the immune system than to the growth of cancer cells.

2.             The capacity for de novo and salvage pathway synthesis of nucleic acids in cancer cells is increased with a concurrent decrease in the activity of key enzymes in nucleotide degradation, suggesting that nucleobases are re-used more efficiently than in non-neoplastic cells. (R.W. Holley; Proc. Natl. Acad. Sci. U.S.A. 69: 2840-2841; G. Weber; Cancer Res. 43: 3466-3492)

This means that cancer cells are able to cover their needs by their own production and re-utilisation of nucleotides, whereas immune cells are fully dependent on external supply.

3.             Because they have smaller nucleotide pools, non-malignant (normal) cells would be more dependent on an external supply of nucleotides. Normal enterocytes are less able to expand their pools in the face of nucleotide supplementation and the pools themselves contain metabolites that are more catabolized than those in the pools of malignant cells. (Ian R. Sanderson and Youping He; The journal of nutrition, Vol.124, January 1994)

This means that the cancer cells are in the position to make better use of their nucleotide pools and therefore are less dependent on an external supply.

4.              When glutamine and non-essential amino acids were present, adding nucleotides had no significant effect on the proliferation of Caco-2 cells (malignant cells). However, nucleotide supplementation increased the proliferation of IEC–6 cells (normal body cells). (Ian R. Sanderson and Youping He; The journal of nutrition, Vol.124, January 1994)

Therefore mostly normal body cells profit from an oral supplementation of nucleotides in combination with a normal uptake of food.

5.             Nucleotides stimulate the Natural Killer Cell Activity and have a positive effect of the Macrophage activation. NK cells are one of the main populations involved in the immune response against transformed cells (J.D. Carver et al; J. Parenter Enteral Nutr 14: 18-22, 1990)

By stimulating the NK cell activity the body is able to fight against carcinogenic cell formation.

6.             DNA and also RNA can suppress the spontaneous growth of transformed cells like, Caco-2 cells. (E. Holen et al ;Nutrition Research 24 :197 – 207, 2004)

By adding RNA in the normal nutrition the development of cancer can even be lowered.

7.        Experiments show that the de novo biosynthesis of nucleotides is sufficient to support the proliferation of neoplastic cell lines but not that of normal cell lines. Nucleotide supplementation may therefore increase the growth and maturation of normal cells. (Ian R. Sanderson and Youping He; The journal of nutrition, Vol.124, January 1994)

Therefore the biosynthesis process is capable of producing sufficient nucleotides for the proliferation of neoplastic cells. Carcinogenic cells are therefore not dependent on an external supply of nucleotides for their fast multiplication.

But oral supplementation of nucleotides increases the proliferation rate of normal body cells. The inability of the cells of the immune systems to produce nucleotides indicates that supplementation orally is paramount to the improved functioning of the immune system increasing its ability to eliminate neoplastic cells from the body.

8.             Researchers showed that the basis for genome instability induced by oncogenes activating the Rb-E2F pathway is uncoordinated S phase entry, leading to insufficient factors required for normal DNA replication. We revealed that cells are forced to proliferate with an insufficient pool of nucleotides to support normal DNA replication. Under these conditions, the replication machinery fails to achieve regular rate and processivity, resulting in DNA damage and genome instability. (A. Bester et al, Cell 145, 435–446, April 29, 2011)

This means that a lack of nucleotides can lead to DNA damage and finally to cancer. Supplementation of nucleotides helps to lower the formation of cancer cell. 

9.             Normal human cells have 46 chromosomes, each of which is a long string of DNA. But in certain bowel cancers, this number can change over time - a process called chromosomal instability. This makes the cells in a tumour incredibly diverse, and helps it become resistant to treatment. Researchers at Cancer Research UK’s London Research Institute and the UCL Cancer Institute found that loss of any one of three particular genes on chromosome 18q interfered with the normal copying process. They were able to dramatically reduce this chromosomal instability in bowel cancer cells lacking the three genes. They did this by adding the basic building blocks of DNA to the cells – called nucleosides - preventing further copying errors from occurring, and the chromosomes from being shuffled.

(R. Burrell et al, Nature 494, 492-496, February 28, 2013)

This means that a lack of nucleotides can lead to DNA damage and finally to cancer. Supplementation of nucleotides helps to lower the formation of cancer cell.

10.          A trial performed at the Department of Experimental Pathology, St Bartholomew`s and Royal London School of Medicine and Dentistry, Charterhouse Square in London showed that there was no statistical evidence that tumour growth was enhanced by the supplement NuCell^®, which contains the Nutri-tide^®IM nucleotide formula.

11.          Over many years of use of the various nucleotide formulations of Pro Bio Ltd no reported increase in cancer incidence in humans or animals has ever been recorded.

Use indications

Supplementary nucleotides should not be taken during Chemotherapy as they potentially interact with the specific treatment. 

They can be taken:

a)      before chemotherapy treatment to help optimise the functioning of the various body systems e.g. immune system or gut, and this helps to minimize the side effects of the cancer treatment,

b)      and/or after finishing the chemotherapy treatment to restore the damaged immune system and the gut structure.

Supplementary nucleotides can be taken before, during and after radiation treatment to help repair damage body cells.

Based on the above information it can be assumed that nucleotide based products do not lead or support a higher incidence of neoplastic cell development.