Cancer - the truth at last
Almost one in two of us will get cancer at some point in our lives. Why is it
rampaging out of control and how can we fight it? To find out, Viva! founder Juliet
Gellatley met Professor Mustafa Djamgoz, Professor of Cancer Biology at Imperial
College, London, and co-author (with Professor Jane Plant) of the book Beat Cancer
"Welcome Juliet, please have a seat”. Professor Mustafa Djamgoz proffers a chair in what appears to be a storage room packed floor to ceiling with boxes, papers and books. I jokingly asked if it was his office – it was! “But I can find anything within two minutes!” he smiled.
We’re in Imperial College, arguably the world’s best university for science. Mustafa was a neurobiologist for over 20 years before turning his sharp and brilliant mind to fighting cancer. He has published more than 200 scientific papers, won several awards, including the Huxley Memorial Medal, and been awarded the Freedom of the City of London.
Professor Jane Plant and Professor Mustafa Djamgoz
I was excited to meet an eminent cancer biologist, whose new book Beat Cancer (co-authored with Viva! Patron and geochemist, Professor Jane Plant), calls for all cancer patients, and those at high risk, to go vegan. Not only that, but Professor Sir Graeme Catto, president of the College of Medicine and former president of the General Medical Council, wrote the foreword and says: “I recommend the book highly not only to cancer patients and their supporters but also the health professionals… I hope they read the book and take on board its key messages to help us all beat cancer.”
Finally, UK academics are publicly acknowledging that a vegan diet helps to protect us from cancer and that high levels of meat and dairy are linked to colorectal, oesophageal, bladder, breast, prostate, gastric, ovarian, kidney and pancreatic cancers – amongst others. This is truly a eureka moment.
Although many of us develop cancer, our chances of survival are better than ever, particularly with early diagnosis. Beat Cancer shows that prevention is becoming a reality and explains what you can do to boost your odds of beating cancer. Divided into 10 self-contained steps, it helps us to understand what cancer is, how to prevent it and how to manage it when diagnosed. I found the book empowering and fascinating.
The first step is to understand what cancer is. It is not a single disease! There are more than 200 types, some driven by hormones, others not. They vary in their biochemical properties and how fast they grow and spread. “Not surprising then”, says Mustafa, “there is no single therapy or treatment that works for all cancers.”
Cancer rates vary wildly across the world and the differences are so stark that we now refer to cancers of affluence or of poverty. In the West, hormone related cancers, such as breast and prostate, are amongst the most common. In poorer nations, cancers caused by stomach, liver and cervical infections are far more prevalent. There are also differences between East and West. Mustafa explains: “The incidence of prostate cancer in Japanese men is one of the lowest in the world yet when they move to the West and eat a Western diet, their risk rapidly rises to the same level as the locals. It cannot be wholly genetic but is related to lifestyle”. In fact, the World Health Organisation say 30-40 per cent of cancers are preventable by a change in diet.
Cells behaving badly
Cancer is our own cells behaving badly. Beat Cancer explains how we are made of more than 100 trillion tiny cells, most of which are constantly reproducing themselves (or we would wear out!). “Cancer happens”, says Mustafa, “when the systems that regulate these processes go wrong – cells lose control and multiply in an uncontrolled way.” Healthy cells divide 50 to 70 times before dying but cancerous cells can divide indefinitely. Their molecular brakes don’t work and they lack the mechanism that triggers cell suicide. Cancer cells invade surrounding healthy tissue and can spread to other areas of the body (metastasise) via the bloodstream or lymph vessels: “It is the ability to spread that makes cancer so dangerous and most cancer deaths are from the metastatic disease, not the original tumour. This is why early detection and vigilance are so important”, says Mustafa. Solid cancers develop in three stages: initiation, promotion and progression.
- Initiation – when the genes that control cell reproduction are damaged, for example by tobacco smoke.
- Promotion – when the damaged cells multiply to form a primary tumour.
- Progression – when the primary tumour develops further and starts to spread.
Crucially, promotion is not inevitable. Imagine the initiated cells as seeds ready to germinate but needing the right conditions to grow. They require water, nutrients, sunlight… otherwise they lie dormant. Cancerprone cells also need certain conditions to multiply. Beat Cancer explains that research links cancer promotion to high levels of growth factors in the bloodstream and, with hormone dependent cancers, high levels of oestrogen and testosterone.
In fact, oestrogen levels are a critical determinant of breast cancer risk and directly participate in the cancer process. Oestrogens are contained in meat and eggs but the main sources are cow’s milk and dairy products, which account for 60 to 80 per cent of all the oestrogens consumed. Mustafa tells me: “Oestrogen is very hard to break down naturally and it passes from cows’ milk to us. Some people think they are protected by pasteurisation but this process does not destroy oestrogen or some growth factors.”
Milk its got the lot
A cow is milked until seven months into her nine-month pregnancy and then again shortly after giving birth. This ensures that milk contains many biologically active molecules. In a typical glass of milk or bite of cheese, there are 35 hormones and 11 growth factors, including IGF-1, oestrogen and progesterone, gonadal, adrenal, pituitary, hypothalamic and other hormones.
IGF wot not?
IGF-1 stands for insulin-like growth factor -1. It is a growth hormone that controls growth and development in both cows and people but each species has very different rates of growth. IGF-1 in cows’ milk crosses our intestinal wall and enters our blood where, it is thought, it encourages our body to produce more of our own IGF-1. Even small increases raise the risk of several common cancers, including breast, prostate, lung and colon.
Mustafa also explains that another, particularly dangerous growth factor is VEGF (vascular endothelial growth factor) which is strongly implicated in the spread of cancer and hence a target for cancer drugs. VEGF also has a vital role in fighting infection by making tissue more permeable, enabling the movement of white blood cells to areas of infection. In the UK, one-third of dairy cows at any given time have the udder disease, mastitis. Their natural VEGF is vital in fighting this so, unsurprisingly, it is found in their milk.
Milk is not the only culprit when it comes to cancer as colon cancer development, for example, is linked to a high intake of red and processed meat.
Bad diet, bad genes
Astonishingly, humans have only 22,000 genes, whilst a banana has 36,000! How? The answer is because 98 per cent of our DNA is made of regulatory proteins that determine which genes are expressed and to what extent. Just because you have a gene, it doesn’t necessarily mean it will be turned on. We are enormously influenced by our environment in this. Mustafa explains: “Think of genes as a string of lights. We used to think that cancer happened when one or more lights in a string was damaged but we now know that some lights can be turned up (up-regulated genes) or turned down (down-regulated genes), switched on or off or somewhere in between”.
So, we now know that cancer depends not just on individual genes but on the interaction between our genes and their surroundings determined by our lifestyle and environment. Mustafa mentioned a stunning trial that demonstrated the power of food in turning on and off genes. Dean Ornish MD, Clinical Professor of Medicine at the University of California, showed that early stage prostate cancer could be reversed by diet and lifestyle changes. The trial, conducted with world-leading microbiologist, Craig Venter, discovered that after only three months on a vegan diet, over 450 cancer genes had been downregulated and 48 protective genes had been up-regulated. Patients with otherwise untreated, early prostate cancer were put into remission.
Beat Cancer gives helpful tables showing what foods to eat, advocating a healthy, varied vegan diet filled with organic fresh fruit and veg, nuts and seeds, pulses and wholegrains. In eating to beat cancer we’re advised to cut out dairy products, processed meats,
refined sugar, refined oils prepared at high temperatures, foods containing preservatives, colourings and artificial flavourings and replace white bread, pasta and rice etc with wholegrain. We should also cut out or vastly limit the amount of meat, fish, eggs, alcohol and coffee. And most definitely, get rid of salt!
Mustafa and the salt connection
I was intrigued to learn about Mustafa’s motivation – what made him study physics and why, as an eminent neurobiologist, he switched to cancer biology: “I was from an early age fascinated by the body’s electrical characteristics when I built a radio transmitter and got several electric shocks! I studied physics and it taught me to understand the physical universe. I then moved into biophysics and studied electrical signals in the brain, which taught me how to understand the biological universe. And now I’m dealing with a pathological universe: cancer.”
Mustafa continued: “It is accepted that electrical signals are important in the brain, heart and muscles so I wanted to know, 1, do cancer cells generate electrical signals and, 2, do aggressive cancer cells differ from those that are benign?” Research by Mustafa and others has shown that aggressive cancer cells – those capable of spreading – are electrically excitable and it is this that makes them hyperactive, invasive and able to spread.
“Aggressive cancer cells act like nerve cells in a state of seizure in an epileptic brain,” he tells me. This happens because those cancer cell genes that control the sodium channel are turned on and sodium floods inside, making them excitable. “So, now we’re developing drugs to block the sodium channel and control the metastatic spread. The good news is that the drugs are not chemotherapy (the side effects are not so severe). A cancer cell will not reproduce out of control without this mechanism.” Mustafa believes we need to change our attitude to cancer and accept that we can live with a primary tumour, so long as it is under control and cannot spread.
He also points out: “Our main dietary source of sodium is salt – it’s a good idea to eat a low salt diet!” Also, guess what increases the expression of the sodium channel gene? Hormones and growth factors, most of which we consume from dairy products. Foods which naturally block the sodium channels include chilli peppers, red grape skins and green tea.
In 2002, Mustafa established a charity which runs the Amber Care Centre in North London, a drop-in centre for anyone affected by cancer. He believes the best cure is prevention and we should all adopt healthier lifestyles – not only a better diet but also, for example, increase our exercise (which amongst other things, modifies the action of hormones and growth factors), and reduce our consumption of alcohol and exposure to pesticides, perfumes and plastics. And, of course, we should stop smoking!
He also believes passionately in vigilance and tells the story of a relative who, in his late 30s, called Mustafa and mentioned that he recently had a little blood in his urine and what should he do about it? Mustafa replied that as it hadn’t recurred he could do nothing; on the other hand, it was not normal so it was better to take action. Two weeks later, Mustafa sat with his relative in a London hospital looking at his X rays. He says: “One kidney
was the size of a tennis ball, the other cancerous and the size of a football, looking like it was going to explode. They operated and he’s still very much alive and kicking! One bit of blood in his urine saved his life.”
If you have cancer, it is imperative to seek specialist care from an oncologist – and ideally one in a teaching hospital that is doing active research. Never try to treat cancer through lifestyle changes, complementary therapies or diet alone. “Cancer is like a juggernaut rampaging through the body uncontrolled. Diet is only one element in helping to stop it but on its own, is not enough.” It is vital that cancer patients seek conventional therapies which very often do work, alongside suitable complementary therapies and psychological support.
Finally, I asked Mustafa if he believed health and cancer charities do enough to prevent cancer through dietary advice. He declared: “The government and health charities say ‘eat a healthy diet’ and it’s meaningless – it is not good enough. It’s an easy option but what does it mean?” So I ask whether GPs and oncologists would ever explain to patients the links between animal products and cancer? “At the end of the day, what will count is scientific evidence. Even the pharmaceutical industry, with its power to manipulate evidence to their advantage, will not stop the truth, it will just take longer.”