Cancer as a Chronic Disease

Well, I'm very excited that coming up here soon, in May, actually May 20th to 23rd in 2010, is the 17th international symposium on functional medicine focused on a very timely topic, and that is cancer, but from a different perspective probably than you've heard of cancer being talked about before. And that is cancer as a chronic disease. How do you manage it now? Why a chronic disease? Over the course of the last few decades, as you know, we've seen an increasing prevalence of certain types of cancers, cancers that are often associated with environmental factors, reducible lifestyle factors. Fortunately, as a consequence of early recognition and new tools of intervention, many of the patients who have these early cancers are now being managed and therefore their management goes on as a chronic disease. They may be worried about recurrence, or they may be in a low grade state of malignancy. So what do they do? It's that question that I think leads us to try to understand the environment in which cancer can develop in the body and how to prevent it from reoccurring, and how to manage a low grade proliferative state of cell replication that's associated with cancer. Remember, cancer is really cancer. It's as varied as there are different kinds of cancers. It's genetically unique. We now talk about personalized cancer therapy that's based upon the unique tissue type of that person's own cancer based on their genes and their genotype. This concept of personalizing cancer therapy is a pretty dramatic new development in the increasing, I would call it sophistication as to how we both diagnose and treat cancer. But there are underlying principles that relate to the environment, or let's call it the soil upon in which cancer can emerge. And this environment, this incubator, has certain characteristics that encourage cellular proliferation, de differentiation, encourage angiogenesis and metastasis. One of those characteristics, and the one that I'll be speaking about at the symposium, which is a modifiable factor, is that of hyperinsulinemia. It's being more and more well recognized that people who have elevated blood insulin levels as a consequence of insulin resistance and metabolic syndrome or pre diabetes are not only at risk to diabetes and heart disease, so called cardiometabolic disease, but they're also at risk to cancer. I know that might seem like a new little spin on the story, but it's a very important story as it emerges. To understand better how to prevent or manage cancer as a chronic disease, the prevention of cancer would be to create the right soil, the right incubator to, to not stimulate the growth and proliferation of These dedifferentiated cancer cells. Hyperinsulinemia is an environmental situation that encourages cancer cell proliferation. So we not only worry about diabetes with hyperinsulinemia and insulin resistance, and we not only worried about arterial disease and atherosclerosis, but now we're also worried about cancer as well. Now, the good news of this story is that the same intervention that we would use to lower the relative risk of diabetes and heart disease would also be the intervention we would use to lower the risk of cancer as a recurrent condition based upon lowering insulin levels, increasing the dietary intervention that stabilizes insulin signaling. Now, how do we do that? I think most of you have heard the low glycemic load modified Mediterranean diet plan, utilizing a diet that's rich in whole grains, fresh fruits and vegetables, low in saturated fats, devoid of transoids, unsaturated fats, low in high glycemic sugars, and easily digested and acetylated carbohydrate fiber devoid diets. In other words, all of those things are characteristic of improving the glucose response and the insulin response after eating, meaning smoothing the insulin and glucose response profile. That also improves, as you know, the postprandial insulin sensitivity at the peripheral cells, so that you're improving in the ability of insulin to signal properly to the cells, which lowers the demand on the beta cells of the pancreas to secrete insulin, causing a much more flat insulin response curve and reducing the state of what's called hyperinsulinemia. And that state of hyperinsulinemia is associated with with increasing risk to diabetes, heart disease, and now we recognize cancers. Beyond that, of course, there are many other insulin stimulating nutrients that are very important as part of the complete well balanced diet. We consider now the emerging role that vitamin D plays in insulin stability. Of course, chromium is a trace mineral. Biotin is one of the B vitamins. Magnesium, of course, a very important mineral in our diet. Certain antioxidants play roles, very important, the trace mineral selenium as the central cofactor in glutathione peroxidase. And then of course, good B vitamin nutriture, including niacin and riboflavin, all play very important roles in modulating these processes associated with insulin signaling and insulin sensitivity. Then you add on top of that the rich new information that's coming available related to certain phytochemicals that are insulin stabilizing phytochemicals. We've heard about the chalcones and cinnamon, for instance, or the epigallocatechin gallates that are in green tea, or the interesting types of flavonoids that are found in mimordica or bitter melon. All of these are known to have insulin stimulating effects. Licorice various types of terpenoid materials have similar insulin stimulating effects. Even recently it's been found that extracts of hops have insulin stimulating effects. So all of these interesting phytochemicals in this rich diet play a role in modulating insulin, which has this effect on setting the right tone for a person who is managing cancers or chronic disease or preventing recurrence. I hope that's some news to you, as you're going to hear much more about this in greater detail at the 17th symposium in the Institute for Functional Medicine.