Ruminations on Cancer
Edition: 2020-12-29
Table of Contents
Introduction
The Undoctored and Wheat Belly programs do not presently include a cancer
treatment Protocol. A focus of the program is to inherently
minimize cancer risk. Here’s an example:
Insulin
is a carcinogen
If you don’t get cancer, you don’t need to treat it.
This article is just my impression of our modern cancer context,
and what might be done if someone has encountered one of the more
extreme consequences of modern living.
Nixon declared War on Cancer in 1971. Presidents
since then have made various symbolic gestures,
with another pricey proposal mooted as I was
initially assembling this article in early 2016. A very few cancers
do have effective treatments, but most do not.
What we primarily have to show for the investment
over the last 47 years is some pretty nifty
gene analysis technology that’s of huge value for
other reasons.
The overall cancer rates and mortality
(net of “all sites”) is
reportedly unchanged since 1950. Finding data and charts for
that is not trivial, because prominently
reporting it apparently supports no one’s
agenda (or funding model). You can easily find charts
showing a slight decrease trend since 1990, but this appears
to be mostly due to a decline in smoking.
Why so little net progress? Well, as with many chronic
non-infectious ailments, the cure may be illusive because
they are almost
certainly digging in the wrong place.
The main impediment in cancer research is probably the
dominant somatic (or gene) theory of cancer, memorialized
in the book Emperor of All Maladies
(Mukherjee, 2001) which purported
to be “A Biography of Cancer”, but
neglected to mention Otto Warburg, even if to dismiss him.
See Tripping Over the Truth: The Return of the Metabolic
Theory of Cancer Illuminates a New and Hopeful Path to a Cure
(Christofferson, 2014, 2nd edition 2017).
A few cancers have a predictable genetic etiology, but
most express genetic chaos, which chaos is not amenable to
the long promised genetic or gene-targeting therapies.
The number of cancer risk factors is growing rapidly.
All sorts of correlations, which may or may not
identify causes, have been found. The California
Proposition 65 list is perhaps the most well-known,
although it notoriously fails to include sugar.
The list itself is probably carcinogenic by now.
So the risk of getting cancer appears to remain high, and
once diagnosed, the outcomes in most cases, under the
Standard of Care (SoC; the consensus treatments)
remain discouraging: expensive, unpleasant, and
offering average life extension often measured in
mere days or weeks.
There are isolated human cultures today that have no or
very little cancer.
What makes them different?
It is thought that Western culture had a dramatically lower
risk of cancer until fairly recently.
What changed?
The answer in both case is:
a lot
How many of those
differences/changes matter?
It could be most of them.[ Return to TOC ]
So if the somatic theory is incorrect, what theories might
we consider that offer some testable possibilities for prevention,
treatment or cure? The number of alternative theories
over the last few decades has ranged from credible to
crackpot.
Perhaps the most prominent of the credible alternate theories is the
metabolic, originally proposed by Warburg in the 1920s,
and more recently revised by Seyfried, who wrote a book
about it
“Cancer as a Metabolic Disease“
(2012). It’s an expensive textbook, but here’s an open summary
from 2014:
Cancer
as a metabolic disease: implications for novel therapeutics
Basically, anything that causes mitochondrial impairment can
lead to cancer in a metabolism predisposed to enable it.
Seyfried himself recommends Christofferson’s book for general audiences.
There are variations of that theory that are also based on
mitochondrial dysfunction, for example Seneff.
Prevention and treatment approaches may be similar on that view.
There’s also a Tissue Organization Field Theory, an
Atavistic Model and
Jack Kruse seems to have his own
“mitonuclear asynchronous disease” theory,
which I haven’t dug into.
The Warburg effect, by the way, suggests a reason why cancer
researchers may be unwilling to look more seriously at the
metabolic theories. The role of glucose amounts
to an indictment of consensus full-time glycemic diets.
Any researcher proposing to prevent or treat cancer by
means of reduced glucose is declaring that the USDA and
DGA committees have been telling people to eat tumor chow
for decades. That further leads to heart disease dogma
being upside down as well. Anyone seeking NIH funding
is probably seriously disinclined to open those cans
of worms.[ Return to TOC ]
Plan A: Avoidance
There may presently be no “cure” for the majority of cancers.
Most of them may turn out to be a largely expected biologic response
to various provocations in too-common metabolic scenarios.
Our bodies may be deflecting these hazards most of the time.
If a site gets out of control, taking extraordinary consensus steps
to kill it may leave us weakened for the next routine episode.
The main thing to do about cancer is to reduce your profile
as a target:
- Adopt a very low net carb, high specific fat, moderate protein diet.
- Eliminate or reduce known triggers in diet.
- Attend to protective micronutrients in diet.
- Obey the sun.
- Reduce exposure to known environmental triggers.
[ Return to TOC ]
1. Low Glucose Diet
A key feature of the metabolic theory of cancer is the
“Warburg Effect” (described in the Seyfried
paper linked earlier). Most tumors thrive on glucose.
Mainstream oncologists use this to image tumors with
tagged glucose (PET
scan). Why consensus oncologists don’t exploit
it for treatment may be an impolite question.
There are a
number of videos available on ketogenic diet, and
a possible role for it in cancer, circa early 2016. If you
only take in one (about a half hour), it might be this one
by Adrienne
C. Scheck, PhD on
ketogenic diet as an adjunct to Standard of Care.
Tumors
can get by on glutamine. They do poorly or die on
ketone bodies. A diet that is 50 grams net carb
per day is at what is generally considered to be the
glycemic/ketotic borderline. Following Undoctored or
Wheat Belly, you are apt to be in ketosis at least
part of the time. On the metabolic theory, this is
unfriendly to tumors (but probably not inherently
therapeutic).
Tumors apparently can also do well
on linoleic (LA)
and arachidonic (ARA) acids, both Omega 6 PUFAs.
Of these, the ω6LA is pervasive in modern so-called
“vegetable” oils derived from grains
and other seeds. ω6LA is also inflammatory. ω6LA is
persistent in the body (can be stored for years),
and released during weight loss “Polyunsaturated
fatty acids are released more rapidly than saturated
fatty acids during long-term energy deficits.”.
Message:
lose
the weight before you get cancer (“But
the 4 people that had worst progression of disease
were also the heaviest with BMIs of 28-31.”)
This does not lead to a conclusion of don’t do KD.
Keeping the weight on is apt to be even riskier.
What it really means is that anyone concerned
about cancer avoidance needs to lose the weight
now, and not wait for a diagnosis.
[ Return to TOC ]
2. Low Trigger Diet
Some elements common in modern diet are known to have a
cancer connection, such as trans fats,
AGEs
and nitrites (including nitrosamine). The Undoctored
and Wheat Belly dietary guidelines warn about those (as do
many cancer authorities).
Avoiding mitochondrial antagonists would appear to be
an exploitable strategy on the metabolic
cancer model. This means minimizing, avoiding, and if unavoidable,
countering antibiotics, and food-like substances that
act like antibiotics. Mitochondria are thought to be
co-opted bacteria, so anything
that suppresses or kills
bacteria could be a problem.
Undoctored and Wheat Belly further warn about common
foods that enable inflammation. This includes the
gluten-bearing grains, principally wheat, and
modern Omega 6
PUFA
industrial seed oils, mainly
LA.
Wheat, in addition to being a
direct gut antagonist, also opens the tight junctions of
the gut wall, which allows its own adverse proteins
and random other toxins into the bloodstream that
should not be there. Mitochondrial mischief is a
likely consequence, if not direct intestinal cancers.
More? Wheat germ oil is 55% ω6LA.
[ Return to TOC ]
3. Key Micronutrients
Immune system support is key in avoiding cancer.
Undoctored and Wheat Belly strongly encourage daily
consumption of varied prebiotic fibers, supporting
a robust microbiome,
a major player in immunity.
Immune therapy, by the way, is an area of active
research in cancer. This recent
article lays out
some of the benefits, hazards and sobering unknowns
of direct intervention
with the immune system.
Intake of 3 grams or more per day of Omega 3
DHA and EPA is advised, as well as ample potassium,
both of which have been shown to be cancer protective
(program target).
For anyone over 40, and for genotypes with low pineal production,
melatonin supplementation needs a serious look. Here’s a 2020-06
roll-up with cites:
IAS AgingMatters:
Melatonin
Stops Cancer!
There are over half a dozen pathways involved in the protective
effect, with science going back decades (and all of it consistent
with the view of cancer as a metabolic disease). As usual, there is
now nothing left to patent, melatonin is relatively cheap (and harmless),
and the medical guilds are unlikely to recapture it as prescription-only.
Ad libitum consumption of fresh non-starchy vegetables is also
encouraged, which provide cancer-protective phytonutrients
in addition to prebiotic fiber.[ Return to TOC ]
4. Multiple Sun Issues
Conventional wisdom on cancer risk says: don’t get too much sun.
What if that’s not just mistaken, but upside down?
Humans are adapted to both sunlight and the clock that the
solar day represents.
Vitamin D
Undoctored
and Wheat Belly advocate a 25-OH Vitamin D titer
of 60 to 70 ng/ml. Vitamin D is known to
be cancer-protective. The optimal/ancestral way to
get D is exposure to sunlight. Most of us, alas cannot do
that due to age, latitude, lifestyle, or some combination
thereof, so we supplement. But get what sun you can.
The “Vitamin D Dilemma” is a long-standing issue.
Based on my personal experience from switching to the Wheat
Belly diet in 2011, I suspect that skin cancer risk is less
a function of sun exposure than diet. Before WB, I used to sunburn
easily and severely. I no longer do.
ipRGCs, uV, blue light
I have a separate article on the Blue
Light at Night hazard which provides detail on this
matter. Cancer is a risk for night time blue light exposure,
most likely due to disruption of pineal melatonin production.
Concordantly, do get blue light, and even ultraviolet light
exposure in the morning, just like your ancestors did.
Don’t wear sunglasses during the day unless you must
(safety or unusually high exposure).
Obey the clock
Keep a wake/sleep schedule synchronized to the local
solar day if possible. Don’t stay up late, and fade
the light to amber if you must stay up. Think twice about
migrating to Mars with Elon.
CaloriesProper: Circadian
rhythms and prostate cancer
BCR: Circadian
clocks and breast cancer
Shift work is a known carcinogen. If you must put up
with it, mitigate the light effects to the extent
possible, almost certainly incluidng deliberate attention
to melatonin. Avoid all (not most, all) exposure to
blue and bright white light during what is supposed
to be your “night”. Sleep in a totally
dark room. Get blue light exposure on arising.[ Return to TOC ]
4. Other Environmental Triggers
In a person on a strongly protective diet, it may turn
out that many “known carcinogens” are
substantially less potent, and perhaps no real threat
at all. But all remain worth opportunistically minimizing
on a precautionary basis, and a few might require more
active steps.
Compared to extant primitive cultures, cancer in
“developed” society is at extraordinary
levels. There may be significant triggers at large,
whose effects are lost in the noise.[ Return to TOC ]
Treatment Options
Hints of the leading edge of metabolic therapies might be found
in this 2018-07 podcast with Peter Attia and Dom D’Agostino:
2:43:05, 115MB download
The most recent comprehensive book on the situation might still be:
The Metabolic Approach to Cancer:
Integrating Deep Nutrition, the Ketogenic Diet, and
Nontoxic Bio-Individualized Therapies (Winters & Kelly, 2017)
It’s endorsed by Seyfried and Christofferson.
If we are confronted with a diagnosis, how does the
metabolic theory inform our therapy choices? (And it
is our choice - let the
oncologist advise, but not dictate.)
I have not been in this situation, but if I had to deal
with it, this is what I would do…[ Return to TOC ]
Get The Latest Advice
This article is not that advice but might provide some leads.
Remediate Diet Immediately, Tweak
This tip may be effective only for cancers that show up
in PET scans. This non-PET caveat apparently applies to most prostate
cancers and glutamine-dependent cancers. For those that
don’t show up, alternatives need
to be considered. Also, if a cancer develops in someone
who has consistently been on a low-carb or keto diet for
many years, further adjustments in diet are apt to be
of very limited value, with perhaps caloric restriction
being the only option there, along with carefully selected
meds and novel supplements.
If I wasn’t following a very-low-net-carb,
grain-free, low-inflammatory, high-specific-fat,
gut-attentive that is low in other suspect
food-like additives, I’d consider it the first
step. The Undoctored recommendations cover this.
Look for additional supplements that are known to be supportive
of mitochondria. Some that come to mind are CoQ10
and NAC
(which latter was mentioned in a paper linked earlier).
Clinics using melatonin typically dose 24 hours, and not just at night.
Prevention is easier than treatment. One of the things it does,
by the way, is interfere with Warburg Effect.
If already on the Undoctored
lifestyle, I’d go even lower net carb (less than 20 grams
per day). This is a ketogenic diet (KD), and it both deprives the
tumors of the glucose they thrive on, and raises blood
levels of ketone bodies, which other cells can run on,
but tumors cannot (at least at the outset). Based on reports to date,
I consider this
a holding or a delay action, and not a full treatment.
More tweaks below.
Drive intake of the PUFA
Omega 6 linoleic acid as low as possible.
ω6LA is the major component of common novel vegetable
oils (refined grain and seed oils). “tumors
selectively take up high amounts of polyunsaturated
fatty acids”. Driving ω6LA down means
learning
where it hides.
In addition to reducing available glucose, take steps to
prevent the remaining glucose from entering cells where it
is not needed. Metformin
might be useful here. In any case, this means minimizing insulin, and that
suggests eliminating dairy, and not using substitute
sweeteners known to provoke an insulin response (even
if brief and mild).[ Return to TOC ]
Do More Homework
This article is not that homework. A fundamental premise of
this article is an intent to be one’s own active
case manager, willing to at least consider
some dissident approaches.
Before I could have a productive conversation with a
provider, I’d need to be conversant with the options
provided under the Standard
of Care for your diagnosis, and have researched
what CAM (Complementary and Alternative Medicine)
have to offer. A key determination for both is data on
outcomes.
Part of the homework is insurance coverage. Are any
CAM modalities covered?
Fortunately, much of approach explored below is very
inexpensive to do independently.[ Return to TOC ]
Find a Collaborative Provider
“Are you willing to work with a self-directed patient?”
might be the first question to ask.
I would let the provider know that I’d been doing research,
and will have questions, but I’d let them make their presentation.
Pay particular attention to whether a prognosis is offered, as
it often isn’t: “Surprisingly, huge numbers of cancer patients
lack basic information, such as how long they can expect to live,
whether their condition is curable or why they’re being prescribed
chemotherapy or radiation, said Dr. Rab Razzak, director of
outpatient palliative medicine at Johns Hopkins Medicine in
Baltimore.”
Then I’d find out if they are open to making adjustment to the SoC,
or even working with me to obtain novel or emerging CAM
treatments.
If they aren’t, and I couldn’t find a provider who will,
I’d consider to what extent I was willing to be non-compliant
with any treatment I consider to be net adverse.
Many people faced with rad or chemo choose no treatment.
It’s tragic that they think submission to the SoC or surrender to the
cancer are the only options.
How about that clinic
in Turkey? I’ll get back to you on that after they drop the
“Vitamin B17”. How about PI3K Inhibitors, Rapamycin,
Mebendazol or Doxycycline?
Yes, there is lots of homework to do.[ Return to TOC ]
Don’t Dismiss the SoC
If you’re going to place your bet on the SoC,
you’re going to get what the SoC delivers,
so make sure you know what that is.
The Standard of Care has effective treatments for
certain cancers. It would be crazy to ignore this option,
but careful attention needs to be paid to:
• elevated risk of future/different cancers, and
• other side effects, in particular
• is loss of appetite/weight loss typical?
If the answer to that last question is “yes”,
a further question must be asked: is the treatment benefit due
to the treatment itself, or the incidental caloric restriction,
if not actual ketosis?
I would also research any treatment adjustments for
ketogenic diet. KD (ketogenic diet) appears to potentiate
both radiation therapy and chemotherapy, and might allow lower dosing.
Personally, if the SoC involved chemo or rad, I’d be
inclined to try a non-invasive approach first.[ Return to TOC ]
FMT Contingency Plan
Conventional cancer therapy is often a disaster for the
gut microbiome. Consensus medicine probably pays no attention
to this, or considers the gut an acceptable casualty
in light of saving the greater organism. It doesn’t
have to be that way.
I would see if I could arrange for an autologous
FMT prior
to commencing any medication. This presumes that there
is no suspicion that the cancer arose from a dysbiosis,
of course. The FMT sample is later used to
repopulate the gut with the same spectrum of micro-organisms
that were there before treatment started. Probiotics,
even prescription probiotics, don’t really provide that.
If the medical profession wasn’t supportive of FMT, I’d
seriously consider a home solution, using frozen samples
and enteric-coated capsules.[ Return to TOC ]
R-KD, IF, Exogenous Ketones, IV-C, 2-DG, 3-BP
This step would require synchronizing with the latest
research. Dominic D’Agostino’s site
is a great resource for that.
Seyfried’s book suggests that a restricted-calorie ketogenic
diet (R-KD or KD-R) might be an effective part of cancer therapy. The
restricted aspect of it is to reduce levels of glutamine, which
tumors can use instead of glucose.
Researcher Dominic D’Agostino further suggests intermittent
fasting (IF) and metformin, which would be tumor stressors
and BG reducers, and more recently in the podcast linked
earlier: IV-C, 2-deoxyglucose (2-DG) and 3-Bromopyruvate (3-BP).
Exogenous
ketones (ExKs) are one or more actual ketone bodies consumed
as if food, rather than synthesized by the body from precursor
foods like MCTs.
This both raises blood ketone levels, and provides energy,
which might provide more flexibility in intake of other foods.
Anyone with factors that put them at higher risk for cancer
probably needs to avoid casual use of ExKs. Reserve them for
urgent situations.
There are several credible
ExK products on the commercial market already, mostly ketone salts,
and a lot of useless “raspberry ketones”.
The ideal products might be research materials unavailable
to the general public. Getting access would probably require
getting enrolled in a trial (with some risk of being in the
placebo arm).[ Return to TOC ]
Hyperbarics and Other Options
Therapies on the metabolic theory are developing rapidly.
One being investigated is hyperbaric oxygen (HbO2).
Here’s an eye-opening paper on a rodent trial:
PLOS|ONE: Non-Toxic
Metabolic Management of Metastatic Cancer in VM Mice:
Novel Combination of Ketogenic Diet, Ketone Supplementation,
and Hyperbaric Oxygen Therapy. D’Agostino suggests
that being in ketosis essential for HbO2 safety.
Other modalities are worth investigating, being sure to
maintain a skeptical perspective and critical thinking.
Various proposed therapies
that turned up that last time I searched included
IV Vitamin C,
high-dose Vitamin D (not clear
if it’s any higher than the 60-70ng/dL
titer routinely suggested by Undoctored),
low-dose naltrexone (LDN),
mitochondria-targeting
antibiotics,
various supplements aimed at inhibiting angiogenesis,
and the usual assortment of botanicals and nutritional potions, most of
which are apt to be wishful thinking (for example: royal jelly is one
— it was recently discovered that what makes queen bee honey
different from regular honey is
what it doesn’t contain, oops).
For prostate cancer, there was recent
news on high-intensity focused ultrasound (HIFU) treatment.
That’s encouraging, because in consensus treatment, outcomes
often differ
little between interventions and doing nothing.
Other recent developments are modified
polio virus for glioblastoma multiforme (GBM) and
Bacillus polyfermenticus and proteasome for multiple myeloma.
[ Return to TOC ]
If the Afflicted is not You
They have to take command of their own situation.
All you can really do is make it known that you
might have some potentially life-saving advice, and are willing
to share it, if the insight is sought.
Chances are this person has not been following
the Undoctored/Wheat Belly lifestyle, and there’s
also some chance you’ve brought that up in the past and
had no luck engaging them on the topic.
Now they have an even more complicated metabolic
situation, and no matter how diplomatic you are,
if they consider these alternatives, they’re
may see it as an
“I told you so”
moment.[ Return to TOC ]
___________
Bob Niland [⎆disclosures] [⎆topics] [⎆abbreviations]