Friday, July 29, 2016

Entropy-based feature extraction and decision tree induction for breast cancer diagnosis with standardized thermograph images

Entropy-based feature extraction and decision tree induction for breast cancer diagnosis with standardized thermograph images

by
Ming-Yih Leea,
Chang Gung University, Graduate Institute of Medical Mechatronics

and

Chi-Shih Yanga,
Lee-Ming Institute of Technology, Department of Mechanical Engineering

a b s t r a c t

In this study, a computer-assisted entropy-based feature extraction and decision tree induction
protocol for breast cancer diagnosis using thermograph images was proposed. First,
Beier–Neely field morphing and linear affine transformationwere applied in geometric standardization
for whole body and partial region respectively. Gray levels of pixel population
at the same anatomical position were statistically analyzed for abnormal region classification.
Morphological closing and opening operations were used to identify unified abnormal
regions. Three types of 25 feature parameters (i.e. 10 geometric, 7 topological and 8 thermal)
were extracted for parametric factor analysis. Positive and negative abnormal regions
were further reclassified by decision trees to induce the case-based diagnostic rules. Finally,
anatomical organ matching was utilized to identify the corresponding organ with the positive
abnormal regions. To verify the validity of the proposed cased-based diagnostic protocol,
71 and 131 female patients with and without breast cancer were analyzed. Experimental
results indicated that 1750 abnormal regions (703 positive and 1047 negative) were detected
and 822 branches were broken down into the decision space. Fourteen branches were found
to have more than 4 positive abnormal regions. These critical diagnostic paths with less
than 10% of positive abnormal regions (61/703 = 8.6%) can effectively classify more than half
of the cancer patients (42/71 = 59.2%) in the abovementioned 14 branches.

1. Introduction

Thermographs were designed to capture the infrared ray from
objects if its temperature were higher than the absolute zero
degree. This special characteristic was utilized to display the
metabolic heat that was dissipated from the skin surface
of human body, especially for the medical thermographs of
breast cancer. The pathological mechanisms of breast cancer
are that cancer cells produce nitric oxide (NO) at proliferative
stage [1]. This chemical material will interfere with the
neuronal control of blood vessel flow and lead up to regional
vasodilatation in the early stage of cancerous cell growth. This
angiogenesis facilitates a local temperature rise about several
years earlier than the tumor forming. And even deep
breast lesions seem to have the ability to induce changes
in skin temperature [2]. The abovementioned characteristics
of breast cancer tissue specifically imply some meaningful
graphic patterns (i.e., geometric size and location, topological
shape or thermal features) in thermograph images. Hence
thermographs are better suited than mammography for early
breast cancer prediction even when the tumor is taking shape.

Medical thermographs become a suitable tool for early warning.
This key point of this paper emphasizes the usage of
thermal image to diagnose breast cancer. The algorithm with
high concentration rate of cancer patients in a few rule paths
was proposed. The effect of early diagnosiswas not in the field
of discussion.

Besides, there exists highly false positive prediction due
to the little difference of thermographs between the normal
subject (negative case) and cancer patient (positive case) as
shown in Fig. 1. Due to the lack of effective image processing
methods to support the use of thermographs, the credibility
and sensitivity of thermographs are still in question in
medical applications. Medical thermograph has been quiescent
for a long time due to the limitation of hardware and
software. The hardware limitation was broken recently by the
advancement of the uncooled focal plane array (UFPA) photo
detector and personal computer, and the software limitation
was also overcame by the progress of analyzing algorithms. All
the signs indicate that the infrared thermal images will be successful
in medical usage [3]. Recently, large scale of case-based
studies showed that thermographs had an average sensitivity
and specificity of 90% as the significant biological risk marker
for the existence of breast tumor [4]. But all these analytical
techniques still come to a standstill with the traditional statistics
and manual evaluation. The parametric analysis on ROI
(region of interest) of hot spots and cold spots in the abnormal
regions still remain unsolved.

Different medical applications with thermographs were
received attention from various research groups. To name a
few, female breast cancer [4,5], pain management [6] or diabetic
foot [7]. Also various digitally analytical methods for
image processing algorithms were proposed, such as abnormal
statistics method [8], the thermal asymmetric method
[9,10] and the image standardization and anatomical matching
methods [11], etc. Although these image processing
techniques are important in medical thermograph analysis,
lots of these methods still lack delicate algorithms or cannot
totally be a part of the computer-assisted diagnosis solution.

The aim of this paper is to establish a computer-aided
cased-based diagnostic tool to automatically interpret the
thermal pattern by a bio-statistical technique [4] for investigating
the parametric connection between female breast
cancer and thermal physiology quantitatively. The proposed
algorithm consists of five steps, i.e. geometric lofting
standardization, abnormal region statistics, parametric factors
analysis, decision tree induction and anatomical organ
matching. This methodology is not intended to replace the
traditionally golden method on mammography and also not
to compare the minimal tumor diameter missed by these two
instruments. This paper is intended to explore the potential
benefits of thermograph for early detection of breast
cancer without comparing its sensitivities or specificities
with that of mammography. In addition, a parametric analytical
algorithm was proposed to extract the governing
rules from large scale dataset by decision tree induction
for breast cancer. Finally, the clinical applicability of
the proposed computer-assisted diagnosis tools was analyzed
by 71 and 131 cases with and without breast cancer
respectively.

Wednesday, July 27, 2016

Cancer Glossary 2

Cancer Glossary 2

What is ?

acute lymphoblastic leukemia (ALL): The most common cancer in children, in whom it is highly curable with chemotherapy. Adult ALL is less common and requires an allogeneic stem cell transplant to achieve cure.

acute myelogenous leukemia (AML): The most common acute leukemia in adults, mainly affecting those sixty years of age and older. Treatment often involves intensive chemotherapy and a stem cell transplant to achieve cure.

adjuvant therapy: Cancer treatments administered after surgery in order to prevent a cancer recurrence.

allogeneic stem cell transplant: The transfer of blood stem cells from one individual (donor) to another (recipient), after treatment of the donor with specific medications; used in the treatment of blood and lymph cancers affecting the bone marrow, such as leukemia.

anemia: Condition when the amount of red blood is lower than the normal range; may contribute to fatigue. Anemia has numerous possible causes, one of which is the administration of chemotherapy.

angiogenesis inhibitors: Cancer-fighting medicines that block the blood supply to a cancer.

apoptosis: The biologic term for the organized process of death experienced by cancer cells in response to cancer-fighting treatments.

autologous stem cell transplant: The removal and return of one’s own blood stem cells, separated by the administration of intensive (“high dose”) chemotherapy to treat blood and lymph cancers, testicular cancer, and some sarcomas.

blood stem cells: The population of cells derived from bone marrow that can reconstitute a person’s bone marrow, blood-forming capacity, and immune system when their own bone marrow has been intentionally destroyed or suppressed as part of the transplant process. Blood stem cells can be driven into the bloodstream and harvested through a catheter in a vein.

bone scan: A radiology test that detects cancer deposits in the bone through the intravenous injection of a radioactive bone-seeking compound.

cancer clinical trial: A research study that enrolls people on a voluntary basis to test the effectiveness of a new way to prevent, diagnose, or treat cancer.

cell: The basic structural building block of all living things.

chromosomes: Rodlike structures found in most living cells that are composed of DNA and proteins required to maintain the DNA. Most human cells have forty-six chromosomes; alterations of normal chromosome structure are commonly found in cancer cells.

chronic lymphocytic leukemia (CLL): The most common type of leukemia, mainly affecting those sixty years of age and older.

chronic myelogenous leukemia (CML): A type of leukemia characterized by an initial chronic phase followed, if not successfully treated, by a more aggressive phase. CML is highly treatable with targeted medicines such as Gleevec.

CT (computerized tomography) scan: Detailed pictures of the inside of the body taken using a sophisticated X-ray machine linked to a computer.

cure: When no evidence of a cancer can be found after treatment for the life of the patient. A cancer is commonly described as cured after a period of time after which the chance of a recurrence is extremely low, such as five or ten years.

EGFR (epidermal growth factor receptor): A molecule on the surface of many cancers that stimulates the cancer to grow; it is the target of a class of cancerfighting drugs, called “EGFR inhibitors,” that include such medicines as Tarceva and Erbitux.

genetic testing for cancer: The analysis of a person’s DNA, derived from a simple blood test, to determine their predisposition to develop specific cancers. The results may enable the person tested and/or his or her family members to prevent cancer if recommended precautions are taken.

genomics: The study of a cancer’s DNA through sophisticated scientific techniques.

informed consent: The process by which a person is fully informed and educated about the risks and benefits of a procedure they may undergo; usually relates to participation in a clinical trial or when considering genetic testing for a family cancer gene.

LDH (lactate dehydrogenase): An easily measurable chemical found in the bloodstream that may be generated in high amounts by rapidly growing cancers, in particular lymphomas.

mediastinum: The area of the human body located in the middle of the chest between the lungs, containing the heart, portions of the aorta and vena cava, main bronchial tubes, thymus gland, lymph nodes, and other structures.

metastasis: The spread of cancer to regions of the body away from the original site of the cancer, for example, when colon cancer spreads to the liver.

MGUS (monoclonal gammopathy of undetermined significance): Condition when an M-spike is detected in the bloodstream but there is no evidence of cancer; patients must be followed for the possible development of multiple myeloma and related disorders.

micrometastases: Cancer deposits that have spread in the body but are too small to be detected by imaging techniques, such as CT scans.

M-protein (also called M-spike): An abnormal protein found in the bloodstream of patients with multiple myeloma, Waldenstrom’s macroglobulinemia, and some other blood/lymph cancers; the protein is made by the cancerous cells and declines in amount with effective treatment. May also be found in MGUS.

MRI (magnetic resonance imaging) scan: Detailed pictures of the inside of the body taken using a sophisticated machine that uses a powerful magnet linked to a computer.

mutation: A change in the DNA sequence that may alter the function of a gene and its corresponding protein. The DNA of a cancer cell is characterized by the presence of numerous mutations.

neoadjuvant therapy: Cancer treatments administered before and in preparation for surgery.

neutropenia: Condition when the bacteria-fighting blood cells called neutrophils are present in levels significantly below the normal range; usually associated with the use of chemotherapy or radiation. Neutropenia places the patient at increased risk for infection.

oncogenes: Normal genes that function abnormally as a result of genetic mutation and that contribute to the development of cancer; many oncogenes are the targets of new cancer-fighting medicines called targeted therapies.

PET (positron emission tomography) scan: A technique to measure the activity level of some cancers through the injection of radioactive glucose (sugar) into the vein.

primary site: The original location where a cancer begins, for example, the breast, prostate, or lung.

prognostic factor: Some aspect of a patient or their cancer used to predict the aggressiveness and survivability of that cancer; for example, being estrogen receptor (ER) positive is a good prognostic factor in breast cancer.

progressive disease: The term used by doctors to convey that a cancer is growing.

PSA (prostate specific antigen): A blood marker of prostate cancer used in screening for the disease and in following the effectiveness of treatment for metastatic prostate cancer.

radiologist: A physician expert at interpreting imaging tests of the human body.
A type of radiologist called an interventional radiologist is expert at performing procedures (such as the placement of a central venous catheter or the instillation of chemotherapy directly into the liver) under the guidance of an imaging machine, such as a CT scan.

recurrence: Regrowth of a cancer after it has been in remission for some time.

remission: The term used to relate that a cancer has stopped growing and has shrunken in size or amount; in a partial remission, the cancer has shrunken by at least 30 percent, whereas in a complete remission, no cancer can be detected.

stable disease: When a cancer has stopped growing but has not significantly shrunken in size or decreased in amount.

staging workup: The battery of tests performed to determine the extent of a particular cancer in the body.

stereotactic radiosurgery: A technique in which high-intensity radiation is focused on a small region of the body in order to eradicate a limited area of cancer.

support group: A meeting of cancer survivors or their loved ones, often led by an experienced professional, to help the participants cope with the many effects of cancer on their lives.

survivor: Anyone who has been diagnosed with cancer.

targeted therapy: A type of cancer-fighting medication designed to bind to one or a few critical targets in a cancer cell.

tumor marker: A chemical measured from the bloodstream and made by a particular cancer that is an indirect measure of the growth of that cancer; for example, many testicular cancers generate a marker called AFP.

tumor suppressor genes: Genes that prevent cancer from developing and are commonly inactivated in many cancers. Mutations in tumor suppressor genes are commonly inherited in families with a predisposition to cancer, such as mutations in the BRCA1 and BRCA2 genes in hereditary breast and
ovarian cancers.

whole brain radiation therapy: Administration of radiation to the entire brain in order to treat the spread of cancer there.

Cancer General Resources 3

Cancer General Resources 3


National Hospice and Palliative Care Organization (NHPCO)

1731 King Street, Suite 100
Alexandria, VA 22314
(703) 837-1500
(703) 837-1233 (fax)
www.nhpco.org
Provides information on hospice services nationally, including information on communication about hospice, insurance coverage and locating hospice services. Provides explanations of palliative care, Medicare benefits, and other frequently asked questions. Information is also available in Spanish.


NeedyMeds, Inc.

P.O. Box 219
Gloucester, MA 01931
(215) 625-9609
www.needymeds.com
Offers information about programs sponsored by pharmaceutical manufacturers to help people who cannot afford to purchase necessary drugs. You can search their Web site for the name of the drug (name brand and generic) to determine if financial assistance plans are available.


New LifeStyles Online

4144 N. Central Expressway, Suite 1000
Dallas, TX 75204
(800) 869-9549
www.newlifestyles.com
Provides information on independent retirement communities, assisted living, nursing homes, Alzheimer’s care, and home or hospice care. You can order a free guide or search online.


The Partnership for Prescription Assistance

(888) 4PPA-NOW (888-477-2669)
www.pparx.org/Intro.php
Through its Web site, “The Partnership for Prescription Assistance offers a single point of access to more than 475 public and private patient assistance programs, including more than 180 programs offered by pharmaceutical companies.”


Patient Access Network Foundation

P.O. Box 221858
Charlotte, NC 28222
(866) 316-PANF (866-316-7263)
www.panfoundation.org
“Patient Access Network (PAN) Foundation is an independent, not-for-profit established in 2004, dedicated to assisting patients who cannot afford the outof-pocket costs associated with their treatment needs” (Web site). Contact the organization for a list of covered diseases; PAN also provides trained case managers with whom patients or advocates may speak about their care.


The Patient Advocate Foundation/Co-Pay Relief Program

700 Thimble Shoals Boulevard
Newport News, VA 23606
(866) 512-3861
(757) 952-0119 (fax)
www.copays.org
“Patient Advocate Foundation is a national non-profit organization that seeks to safeguard patients through effective mediation, assuring access to care, maintenance of employment and preservation of their financial stability relative to their diagnosis of life threatening or debilitating diseases” (Web site). The Co-Pay Relief Program provides direct co-pay assistance for pharmaceutical products to insured patients who financially and medically qualify, for a restricted number of specific cancers; contact the organization for a list of covered conditions.


Social Security Administration (SSA)

Office of Public Inquiries
Windsor Park Building
6401 Security Boulevard
Baltimore, MD 21235
(800) 772-1213
(800) 325-0778 (TTY)
www.ssa.gov
This Federal program provides extensive information on Social Security benefits, including Social Security Disability (SSD), Medicare, Supplemental Security Income (SSI), contact information to state Medicaid offices, and much more. You may be able to apply online to these programs, and even
check your claim status. Information is available in many languages; call or check the Web site for a complete list.


United Ostomy Associations of America, Inc. (UOAA)

UOAA
P.O. Box 66
Fairview, TN 37062-0066
(800) 826-0826
www.uoaa.org
The UOAA “is an association of affiliated, nonprofit, support groups who are committed to the improvement of the quality of life of people who have, or will have, an intestinal or urinary diversion” (Web site). Coordinates educational and support groups through local chapters, and publishes The Phoenix.
Provides information on practical ostomy care issues, including answers to common insurance coverage questions, and support information.


The United Way

(703) 836-7112
www.liveunited.org
“The United Way is a national network of nearly 1,300 local organizations that work to advance the common good by focusing on education, income and health” (Web site). For information about specific United Way programs in your area or other social services available in your area (including, in some locations, financial assistance programs), contact your local chapter of the United Way.


U.S. Department of Health and Human Services (HHS)

200 Independence Avenue, SW
Washington, DC 20201
(877) 696-6775
www.hhs.gov
The mission of this government organization is to “protect health and give a special helping hand to those who need assistance.” HHS provides information on many topics, including Medicare, Medicaid, childcare and health initiatives, referrals to information on cancer, and much more. HHS publishes the “Guide to Health Insurance for People with Medicare.”


U.S. Department of Labor

Frances Perkins Building
200 Constitution Avenue, NW
Washington, DC 20210
(866) 4-USA-DOL (866-487-2365)
www.dol.gov
The U.S. Department of Labor has created an online program to help people understand their eligibility for and rights regarding the Family and Medical Leave Act  (www.dol.gov/elaws/esa/fmla/fmlamenu.asp). Additional information regarding employee rights, including health plans and benefits, is available on the e-laws section of the Web site.


The Wellness Community

National Office
919 18th Street, NW
Suite 54
Washington, DC 20006
(888) 793-WELL (888-793-9355)
(202) 659-9709
www.thewellnesscommunity.org
This organization provides supportive services to people with cancer and their loved ones by offering a variety of services, including online information and support (through the “Virtual Wellness Community”) and on-site locations nationwide. Also includes a list of suggested books addressing common issues people with cancer and their families face. Information is provided in both English and Spanish.

Stress and emotions as CANCER TRIGGERS

Stress and emotions


While diet and exercise may play a big role in health, emotional well-being is just as important. Johannesburg-based psychologist Melissa Card says: ‘Some people believe in a mind-body connection, while others do not. Regardless of whether you believe in this connection or not, research has shown that our bodies react to the way we think and feel about situations.’

Examples of this include high blood pressure and ulcers caused by extremely stressful situations, especially in people with no family history of such conditions. ‘Negative emotions such as anxiety, doubt, fear and frustration can affect our health to a large extent,’ says Card. ‘Most of life’s
uncertainties, like finances, employment, marriage, education, divorce or death, can have a detrimental effect on one’s mental and emotional health, if not dealt with in an appropriate manner, which can in turn affect the body.’

Our bodies send us signals when we are not coping with stress. The most common include chronic fatigue, irritability, stomach problems, significant weight fluctuations (gain/loss), changes in appetite, neck pain and backaches, insomnia, sexual dysfunction, breathing problems and decreased immunity.

If you are aware of some of these symptoms when you are feeling stressed, it could be time to slow down and take stock of where you are in your life.

‘When we feel overwhelmed and bogged down by everything happening around us, we tend to neglect our bodies and health,’ says Card. ‘When one is anxious, fearful, depressed or frustrated, it’s easier to indulge in all the negative “stress relievers” or addictive tendencies, such as alcohol, smoking, bad eating habits (comfort food) and even drug abuse – all of which ultimately have a detrimental effect on our physical and mental well-being.’

Luckily, these symptoms and feelings can easily be reversed, by getting enough sleep, following a balanced diet and engaging in regular exercise, which, Card explains, not only has a beneficial effect physically but also in terms of emotional well-being. Setting realistic goals may also be helpful when
it comes to maintaining emotional health. ‘We’re often left with many negative emotions when we cannot or do not reach the goals we’ve set for ourselves, and thus allow for stress to creep in and overwhelm us,’ Card explains. Adopting coping mechanisms like relaxation techniques, walking,
reading, listening to music, yoga and meditation can play a big role in giving you a break from your stressful lifestyle.

When it comes to life-threatening illnesses like cancer, Card acknowledges that emotions like fear, sadness, anger, disbelief and dismay can be overwhelming. She advises trying not to overthink or overanalyse the situation, as this could lead to unnecessary worry and the secretion of stress chemicals. ‘Regular exercise does help with this by releasing other chemicals to counter the negative emotions. Expressing yourself is always better than bottling everything up. If you are not able to speak to close friends and family, perhaps try a counsellor or therapist, doctor or religious advisor, whomever you feel comfortable with.’

She adds that one of the most important things you can do is ensure that you have social support to help you cope. Journaling, painting or drawing may also serve as forms of expression while dealing with the stress of illness.


CHOCOLATE FUDGE RECIPES by Noel Marten & Natalie Reid

CHOCOLATE FUDGE RECIPES by Noel Marten & Natalie Reid


MAKES ABOUT 40 PIECES


1 cup pitted dates
1⁄2 cup warm water
1 cup coconut oil
1⁄2 cup cocoa powder
1 tsp vanilla powder
pinch of salt


1. Soak the dates in the water until soft.
2. Place all the ingredients in a food processor or blender and process with the S-blade until completely smooth and mixed. This takes up to 20 minutes.
3. Pour the mixture into a shallow dish and refrigerate for 3–4 hours until set.
4. Cut into squares and store in an airtight container in the fridge.


Notes
Add flavours such as mint, sweet orange, rose geranium or lavender. When
using essential oils in food, remember to use food grade only.

FRAN COSTIGAN’S BANANA BREAD RECIPES by Allison Gilbert

FRAN COSTIGAN’S BANANA BREAD RECIPES by Allison Gilbert


MAKES 1 LOAF


3⁄4 cup wholewheat pastry flour
1⁄4 cup cake flour
1 tsp aluminium-free baking powder
1 tsp ground cinnamon
1⁄2 tsp bicarbonate of soda
1⁄4 tsp fine sea salt
2 ripe bananas, peeled and mashed well (about 2⁄3 cup)
140 ml soy milk
1⁄2 cup pure maple syrup, grade B or dark amber
3 Tbsp mild-tasting extra-virgin olive oil or organic canola oil
1 tsp each of pure vanilla extract and apple cider vinegar
1⁄2 cup toasted and coarsely chopped walnuts (optional)


1. Preheat the oven to 190 °C and grease a 21 x 11 cm loaf tin.
2. Sift the flours, baking powder, cinnamon, baking soda and salt into a medium-sized bowl. Stir with a wire whisk to distribute and aerate the mixture.
3. Combine the bananas, milk, maple syrup, oil, vanilla extract and vinegar in a separate bowl, mixing until well blended. Pour this into the dry mixture and stir only until the batter is smooth.
4. Stir in the walnuts (if using) and spoon the batter into the prepared tin. Smooth the top and bake on the middle shelf of the oven for 50 minutes, until the loaf has risen and is golden brown. A skewer inserted into the centre should come out clean. Bake longer if needed. If the loaf is browning too much, reduce the oven temperature to 170 °C.
5. Cool the tin on a rack for 10 minutes. Run a knife between the loaf and the tin, and turn out the loaf onto the rack to cool completely. When cool, tightly wrap in cling wrap and store at room temperature for about 8 hours before slicing.


Notes
In order to make the most flavourful banana bread, the bananas must be very
ripe. However, when bananas are overripe or bruised, they have an
unpleasant fermented odour and taste, so use them at their peak. Mash well,
but do not purée.

BROCCOLI PASTA RECIPES by Christopher Weiss

BROCCOLI PASTA RECIPES by Christopher Weiss


SERVES 4


250 g bacon, chopped
1 full head broccoli
5 Tbsp olive oil
1 fresh chilli, chopped
1 Tbsp finely chopped anchovies
salt and freshly ground black pepper to taste
500 g cups spaghetti

1. Fry the bacon bits in a frying pan until crispy and set aside.
2. Break the florets off the broccoli head and set aside. Place the broccoli stem, olive oil, chilli and anchovies in a blender or food processor and blend into a sauce, adding enough water to keep it liquid.
3. Tip this sauce into a saucepan and bring to the boil on the stove for 10 minutes, adding water as needed. Season to taste.
4. In the meantime, cook the pasta according to the packet instructions. When the pasta is cooked, add the broccoli florets and allow to boil for 1 minute.
5. Drain the pasta and broccoli and toss through the bacon and sauce. Serve immediately.

TASTY LAMB WRAPS RECIPES by Nicolette Hall

TASTY LAMB WRAPS RECIPES by Nicolette Hall


SERVES 4


2 Tbsp olive oil
600 g lamb strips
1 medium onion, peeled and cut into rings
2 cloves garlic, peeled and crushed
1 large red pepper, deseeded and julienned
1 large green pepper, deseeded and julienned
1 large yellow pepper, deseeded and julienned
125 g button mushrooms, sliced
440 g can pineapple pieces, drained (optional)
1⁄2 tsp ground mixed spice
salt and freshly ground black pepper to taste
4 flour tortillas


GUACAMOLE
1 large avocado, peeled, pitted and chopped
1 Tbsp lemon juice
1 Tbsp chopped fresh coriander or parsley
1 small tomato, finely chopped


1. Preheat the oven to 180 °C.
2. Heat the olive oil in a heavy-based saucepan. Add the lamb strips and fry until golden brown.
3. Add the onion, garlic, peppers, mushrooms, pineapple (if using) and mixed spice, and season to taste.
4. In the meantime, warm the tortillas in the oven for 5–10 minutes.
5. To make the guacamole, mash the avocado in a small bowl and mix in the remaining ingredients.
6. Spoon the lamb filling onto the tortillas and roll up like a wrap. Cut in half and serve with the guacamole on the side.

SWEET AND SOUR BEEF STIR-FRY RECIPES by Catherine Boome

SWEET AND SOUR BEEF STIR-FRY RECIPES by Catherine Boome


SERVES 4–6


1 Tbsp olive oil
480 g lean beef, fat removed and cut into strips
4 cloves garlic, peeled and crushed
1 red pepper, deseeded and cut into thin strips
1 yellow pepper, deseeded and cut into thin strips
4 medium carrots, peeled and julienned
1 cup mange tout/snap peas
SAUCE
1⁄2 cup tomato sauce
2 Tbsp soy sauce
2 tsp honey
1 tsp salt
1 Tbsp olive oil
1⁄2 cup chicken stock
2 Tbsp cornflour, dissolved in 1⁄3 cup water


1. Heat the olive oil in a large frying pan or wok and stir-fry the beef until seared on all sides. Remove the beef and set aside. Add the garlic, peppers, carrots and peas to the pan/wok and stir-fry for 3–5 minutes until the vegetables are done to your liking.
2. In the meantime, bring the sauce ingredients to the boil in a saucepan.
3. Add the sauce to the vegetables in the pan/wok, and then add the meat and heat through before serving.

YOGHURT CHICKEN RECIPES by Kerry Brown

YOGHURT CHICKEN RECIPES by Kerry Brown


SERVES 4–6


4 chicken breasts
1 cup fat-free plain yoghurt
1 clove garlic, peeled and chopped
1 tsp chopped fresh ginger
1 onion, peeled and chopped
1⁄2 tsp chopped chilli (or a sprinkle of cayenne pepper)
squirt of honey
dash of soy sauce
1 Tbsp chopped fresh coriander to serve


1. Preheat the oven to 180 °C.
2. Place the chicken breasts in an ovenproof dish. Combine all the remaining ingredients and evenly spread over the chicken.
3. Bake for 30 minutes or until cooked through.
4. Scatter over the coriander and serve with your choice of green vegetables (‘I would suggest mange tout and broccoli’).

BAKED CHICKEN DISH RECIPES by Lindsey Tainton

BAKED CHICKEN DISH RECIPES by Lindsey Tainton


SERVES 4–6


1 Tbsp olive oil
250 g bacon, chopped
11⁄2 cups sliced mushrooms
2 large carrots, peeled and chopped
5 spring onions, chopped
300 ml chicken stock
2 chicken breasts, chopped
1–2 sheets butter pastry
1 egg, beaten


1. Heat the olive oil in a large saucepan and fry the bacon until almost cooked. Add the mushrooms and fry until cooked. Then add the carrots and spring onions and simmer until soft.
2. Add the stock and simmer for a further 10 minutes. Then add the chicken and simmer for 20 minutes until the mixture has thickened.
3. Remove from the heat and allow to cool before tipping into an ovenproof dish.
4. Preheat the oven to 200 °C.
5. Roll out the pastry and use it to cover the chicken dish. Brush with the beaten egg and bake for 25–35 minutes.

CHICKEN BREASTS RECIPES by Gerda Fouché

CHICKEN BREASTS RECIPES by Gerda Fouché


SERVES 3


1⁄4 cup olive oil
1 Tbsp soy sauce
2 cloves garlic, peeled and crushed
1 Tbsp minced fresh root ginger
1 Tbsp Dijon mustard
salt and freshly ground black pepper to taste
6 skinless, boneless chicken breasts


1. Mix the olive oil, soy sauce, garlic, ginger, mustard, salt and pepper and brush on the chicken breasts. Refrigerate for at least 30 minutes or overnight.
2. Preheat the oven’s grill.
3. Grill the chicken breasts for about 6 minutes on each side, depending on their thickness. Rest the chicken on a plate for 2 minutes before serving.

BAKED FISH RECIPES by Tammy Wolhuter

BAKED FISH RECIPES by Tammy Wolhuter


SERVES 4


1 Tbsp olive oil
1 medium onion, peeled and finely chopped
1 clove garlic, peeled and crushed
450 g ripe tomatoes, chopped
salt and pepper to taste
110 g mushrooms, sliced
1 Tbsp chopped fresh basil leaves
1 Tbsp chopped capers
4 thick white fish fillets
juice of 1⁄2 lemon
1⁄2 cup pitted olives


1. Preheat the oven to 190 °C.
2. Heat the olive oil in a saucepan and fry the onion until soft.
3. Add the garlic and tomatoes and season with salt and pepper.
4. Simmer uncovered for 15 minutes, stirring occasionally.
5. Stir in the mushrooms and simmer for a further 10 minutes until the sauce has thickened.
6. Add the basil and capers, and remove from the heat.
7. Place the fish fillets in a shallow baking dish and sprinkle each with a little lemon juice.
8. Spoon an equal amount of sauce onto each fish fillet and arrange a few olives on top.
9. Cover with foil and bake on the top shelf of the oven for about 25 minutes.
10. Serve with a tossed green salad.

Tuesday, July 26, 2016

DR ROBERTS’S VEGETARIAN BOBOTIE RECIPES by Kathia Roberts


SERVES 8–10


2 Tbsp olive oil
2 red onions, peeled and chopped
1 clove garlic, peeled and crushed
1 Tbsp chopped fresh origanum
400 g soya mince
1⁄2 tsp ground cardamom
1⁄2 tsp ground paprika
1 tsp curry powder
pinch of sea salt
pinch of cayenne pepper
1 Tbsp raw brown sugar
1 Tbsp chutney or apricot jam
1 Tbsp cranberry vinegar
1 Tbsp lemon juice
1 Tbsp Worcestershire sauce
1 cup halved cashew nuts
1⁄2 cup sultanas
1⁄2 cup raisins
2 plums, peeled and chopped
2 apricots, peeled and chopped
1 cup milk
2 eggs
1 slice wholewheat/spelt bread
7 whole bay leaves


1. Heat the olive oil in a large frying pan and sauté the onions, garlic and origanum.
2. Add the soya mince and sauté until lightly browned.
3. Combine the spices, sugar, chutney or jam, vinegar, lemon juice and Worcestershire sauce and add to the mince.
4. Add the nuts and fruit and stir until well mixed.
5. Preheat the oven to 180 °C and grease a large ovenproof dish.
6. Whisk the milk and eggs in a bowl and soak the bread in the mixture. Mash and drain the bread, saving the liquid for later. Add the bread to the mince and stir to combine.
7. Tip the mince mixture into the prepared dish and spread out evenly. Pour over half of the remaining egg and milk mixture and scatter over the bay leaves.
8. Cover with foil and bake for 30 minutes, then remove from the oven and pour over the remaining egg and milk mixture.
9. Bake uncovered for a further 10 minutes until brown.
10. Serve on a bed of turmeric yellow rice with coconut flakes and chopped tomatoes on the side.

THAI SOM THUM RECIPES by Noel Marten & Natalie Reid

THAI SOM THUM RECIPES by Noel Marten & Natalie Reid


SERVES 4–6


1 cup julienned cucumber
1 cup julienned daikon
1 cup roughly chopped fresh coriander
1 Tbsp thinly sliced fresh chilli
1 Tbsp minced fresh root ginger
1 Tbsp minced fresh garlic
1 Tbsp lime or lemon zest
3 Tbsp lime or lemon juice
1 Tbsp light sesame or macadamia nut oil
1⁄4 tsp salt
1 cup papaya shavings


1. Toss everything together, except the papaya, and allow to marinate for about 10 minutes.
2. Just before serving, add the papaya shavings and turn over very gently to coat.

SWEET AND SOUR QUINOA RECIPES by Natascha Wolf

SWEET AND SOUR QUINOA RECIPES by Natascha Wolf


SERVES 4


1 cup quinoa
2 cups vegetable stock
1⁄3 cup sunflower seed, pumpkin seed and pine nut mixture
1⁄3 cup raisins
1⁄4 cup finely sliced dried apricots
1⁄3 cup finely sliced sundried tomatoes
small bunch fresh flat-leaf parsley, chopped
small bunch chives, chopped
2 Tbsp olive oil
1 Tbsp lemon juice
salt and freshly ground black pepper to taste

1. Place the quinoa in a large saucepan and pour over the stock, cover with a lid and bring to the boil. Once boiling, reduce the heat to low and gently simmer for about 15 minutes or until the quinoa has absorbed all the stock. Fluff the quinoa with a fork and set aside.
2. Toast the seed and pine nut mixture in a dry frying pan over medium heat for 6–8 minutes or until golden, shaking the pan every few minutes to prevent scorching.
3. Transfer the cooked quinoa to a large serving bowl, add the raisins, apricots, sundried tomatoes, herbs and toasted seeds and pine nuts, and stir.
4. Drizzle over the olive oil and lemon juice, season well and toss before serving.

TOMATO SOUP WITH BASIL OIL RECIPES by Martin Connolly

TOMATO SOUP WITH BASIL OIL RECIPES by Martin Connolly


SERVES 6


15 ripe plum tomatoes
3 medium red peppers, deseeded and chopped
100 ml extra-virgin olive oil
6 red chillies, deseeded and chopped
salt to taste
1 clove garlic, peeled and finely chopped
2 Tbsp red wine vinegar
550 ml vegetable stock
2 good handfuls fresh basil leaves


1. Blanch the tomatoes in boiling water, remove the skins, deseed and roughly chop.
2. Preheat the oven’s grill and grill the red peppers whole until the skins are blackened. Allow to cool, then remove the skins, deseed and roughly chop.
3. Warm 2 Tbsp olive oil in a large saucepan and slowly fry the peppers, chillies and a pinch of salt for about 5 minutes. Add the garlic and fry for a further 2 minutes. Then add the tomatoes, red wine vinegar and another pinch of salt, and cook for 10 minutes to infuse.
4. Add the stock and simmer for 15 minutes. Blend with a hand blender to ensure a smooth consistency and season to taste.
5. In a pestle and mortar (or food processor), smash the basil to a pulp with a pinch of salt. Stir in the remaining olive oil and a drop of red wine vinegar.
6. Generously drizzle the basil oil over the soup, and enjoy with crusty bread.

BEEF AND VEGETABLE SOUP RECIPES by Taryn Rutenberg

BEEF AND VEGETABLE SOUP RECIPES by Taryn Rutenberg


SERVES 4–6


2 meaty beef shin bones
salt
1 litre water
2 onions, peeled and grated
2 large carrots, peeled and grated
2 potatoes, peeled and grated
2 turnips, peeled and grated
1 stick celery (stems and leaves), finely chopped
small handful fresh parsley, finely chopped
freshly ground black pepper to taste
1 beef stock cube (optional)


1. Make beef stock by boiling the shin bones with a little salt in the water until the meat is soft.
2. Remove the bones, cut the meat into small pieces, and then return the meat and marrow to the stock.
3. Add the vegetables, celery and parsley and boil gently until the vegetables are soft.
4. Season to taste with salt and pepper, and add the beef stock cube if necessary to enhance flavour.

TOFU AND QUINOA SALAD RECIPES by Karen Lange

TOFU AND QUINOA SALAD RECIPES by Karen Lange


SERVES 4


1 cup organic quinoa
11⁄2 cups water
500 g earth tofu, cut into 8 blocks
2 Tbsp soy sauce
1 Tbsp olive oil
200 g mixed salad leaves
35 g crimson micro-leaves
3 Tbsp organic apple cider vinegar
1 Tbsp organic balsamic vinegar
1⁄2 Tbsp organic 3, 6, 9 omega blend oil
drizzle of Tamari sauce
250 g Rosa tomatoes, halved
handful pitted dried olives
1⁄2 avocado, chopped
freshly ground black pepper to taste


1. Rinse the quinoa in a colander under cool running water for 2–3 minutes.
2. Add the quinoa to the water in a saucepan and steam for 30–40 minutes until soft.
3. Marinate the tofu in the soy sauce for 10 minutes.
4. Heat the olive oil in a frying pan and fry the tofu for 2 minutes on each side until slightly brown and tender. Remove from the heat.
5. Combine the remaining ingredients in a salad bowl and gently toss with the quinoa and tofu before serving.

RAW CARROT AND BEETROOT SALAD RECIPES by May Smith

RAW CARROT AND BEETROOT SALAD RECIPES by May Smith

SERVES 4

2 carrots, peeled and grated
1 beetroot, peeled and grated
2 cloves fresh garlic, peeled and finely grated
2 cm piece fresh root ginger, peeled and grated
1 tsp each of sunflower, pumpkin and black mustard seeds
small handful chopped fresh coriander with stalks
1 Tbsp olive oil
1 Tbsp lemon juice


1. Combine the carrots, beetroot, garlic and ginger in a salad bowl.
2. Sprinkle over the seeds and coriander, and drizzle over the olive oil and
lemon juice.

LENTIL, BEETROOT AND ROCKET SALAD RECIPES by Nathalie Mat

LENTIL, BEETROOT AND ROCKET SALAD RECIPES by Nathalie Mat

SERVES 2

1⁄2 cup baby beetroot halves
1 Tbsp balsamic vinegar, plus extra for dressing
1 tsp olive oil, plus extra for dressing
2⁄3 cup cooked brown lentils
11⁄2 cups rocket leaves


1. Preheat the oven to 220 °C.
2. Place the baby beetroot in a shallow baking dish and drizzle over the balsamic vinegar and olive oil. Cover with foil and roast for 30 minutes or  until soft.
3. Combine the lentils and roasted beetroot, and dress with extra balsamic vinegar and olive oil.
4. Arrange the rocket leaves on a platter and top with the beetroot and lentils.

BERRYLICIOUS SMOOTHIE RECIPES by Catherine Boome

BERRYLICIOUS SMOOTHIE RECIPES by Catherine Boome

SERVES 2

11⁄2 cups (about 280 g) mixed berries
1 cup cranberry juice
11⁄2 cups fat-free plain yoghurt
ice cubes

1. Blend all the ingredients together in a blender.

GREEN JUICE RECIPES by Barbara Leiman

GREEN JUICE RECIPES by Barbara Leiman

SERVES 1

1 celery stick with leaves
pinch of chopped fresh parsley
3–4 spinach leaves
1⁄4 cucumber, sliced
1 apple, cored and sliced
1⁄2 cup kale
1⁄2 cup pak choi
juice of 1⁄2 lemon
small piece of peeled fresh root ginger

1. Blend all the ingredients together in a blender.

GREEN SMOOTHIE RECIPES by Jennifer Thompson

GREEN SMOOTHIE RECIPES  by Jennifer Thompson

SERVES 1

2 handfuls Romaine lettuce
1 handful rocket leaves
1 red bell pepper, deseeded and chopped
1⁄4 red onion, peeled and chopped
1⁄2 clove fresh garlic, peeled and chopped
2 Tbsp hemp protein
1 Tbsp flax oil
1 cup water
1 tsp ground turmeric
dash of ground coriander
Himalayan sea salt and cayenne pepper to taste


1. Blend all the ingredients together in a blender.

Cancer General Resources 2

Cancer General Resources 2


Gilda’s Club

Gilda’s Club Worldwide
48 Wall Street, 11th Floor
New York, NY 10005
(888) GILDA-4-U (888-445-3248)
“The mission of Gilda’s Club is to provide meeting places where men, women and children living with cancer and their families and friends can join with others to build emotional and social support as a supplement to medical care.
Free of charge and a nonprofit, Gilda’s Club offers support and networking groups, lectures, workshops, and social events in a nonresidential, homelike setting” (Web site). The organization is named after the comedian, Gilda Radner, who died of cancer. Call or visit the Web site to learn more about the support services they provide and to find out if there is a club in your area. An online directory of cancer type-specific resources is available. Information on the Web site is offered in both English and Spanish.


Health Resources and Services Administration (HRSA)

Hill-Burton Program
U.S. Department of Health and Human Services
Parklawn Building
5600 Fishers Lane
Rockville, MD 20857
(800) 638-0742
(301) 443-5656
(800) 492-0359 (if calling from the Maryland area)
Under the aegis of the U.S. Department of Health and Human Services, the HRSA Web site provides information on many government initiatives and programs related to providing health care to low income and disadvantaged populations.


The HealthWell Foundation

P.O. Box 4133
Gaithersburg, MD 20878
(800) 675-8416
The HealthWell Foundation is a nonprofit, charitable organization that helps individuals with out-of-pocket healthcare costs such as insurance copayments, premiums, and coinsurance, for a select number of cancer diagnoses; contact the organization for a specific list of eligible conditions.


Language Line Services

1 Lower Ragsdale Drive, Bldg. 2
Monterey, CA 93940
(800) 752-6096
Provides “Personal Interpreter” and “Personal Translator” services in 170 languages from any phone. There is a fee to use these services if your hospital or physician does not have a contract with the company; you can use a credit card to pay. The Web site also provides a description of the services provided, including document translation.


Meals on Wheels

203 S. Union Street
Alexandria, VA 22314
(703) 548-5558
This organization provides home-delivered meals to those in need, such as people who have trouble grocery shopping or cooking their own food. The Web site allows you to search for local programs.


National Cancer Institute (NCI)

NCI Public Inquiries Office
6116 Executive Boulevard, Room 3036A
Bethesda, MD 20892-8322
(800) 4CANCER (800-422-6237): Spanish-speaking operators available
Provides extensive information about health-related issues, including information on cancer. The Web site includes information on how to cope with specific treatment side effects, such as pain and fatigue, information on support and coping, and the latest on cancer treatment and prevention. The NCI publishes a variety of pamphlets and other publications that you may find informative (in English and Spanish).


National Center for Complementary and Alternative Medicine

National Institutes of Health
9000 Rockville Pike
Bethesda, MD 20892
(888) 644-6226
This site provides information regarding disease-specific alternative and complementary therapies. The site covers the basics on using these therapies, where to find doctors, research, and clinical trials all related to complementary and alternative medicine. Some information available in Spanish.


National Coalition for Cancer Survivorship (NCCS)

1010 Wayne Avenue, Suite 770
Silver Spring, MD 20910
(301) 650-9127
(888) 650-9127
NCCS acts as a clearinghouse for information about survivorship and empowers cancer survivors through its publications and programs. They publish useful pamphlets and books on many aspects of managing the medical, financial, and emotional aspects of cancer. You can order, or listen online to, the “Cancer Survivor’s Toolbox” (produced in conjunction with the Association of Oncology Social Work and the Oncology Nursing Society, and available in Chinese, English, and Spanish). Publishes and sells a variety of useful books and pamphlets.


National Comprehensive Cancer Network (NCCN)

275 Commerce Drive, Suite 300
Fort Washington, PA 19034
(215) 690-0300
(888) 909-NCCN (888-909-6226)
(215) 690-0280 (fax)
This site provides information about cancer treatment centers around the United States. It gives specific information regarding those institutions, their specialties, facilities, and resources. Starting in 2009, the NCCN will publish summaries of treatments available for many types of cancer.


National Family Caregivers Association (NFCA)

10400 Connecticut Avenue, Suite 500
Kensington, MD 20895-3944
(301) 942-6430
(800) 896-3650
Espousing a philosophy of self-advocacy and self-care, the NFCA provides a variety of educational materials (available through their Web site) to support family caregivers.

Cancer General Resources

Cancer General Resources



American Cancer Society (ACS)

American Cancer Society National Home Office
1599 Clifton Road
Atlanta, GA 30329
(800) ACS-2345 (800-227-2345)
www.cancer.org
ACS is an excellent resource for a wide range of issues, including information on the medical aspects of cancer, coping and family issues, making medical decisions, and much more. In addition to its superb Web site, ACS also publishes a variety books and pamphlets, facilitates support groups and lectures run by local ACS offices (you can search the Web site or call for program details), and is involved in advocacy and government policies issues. In some locations, ACS provides limited financial assistance to people in financial need undergoing treatment for cancer. Some information is available in Spanish.


American Society of Clinical Oncology

2318 Mill Road, Suite 800
Alexandria, VA 22314
(888) 282-2552
www.asco.org
www.cancer.net
The American Society of Clinical Oncology is a 501(c)(3) nonprofit and represents over 25,000 cancer professionals worldwide. A section of the Web site, called “Cancer.Net” provides information on cancer prevention and treatment, as well as other useful resources, such as podcasts, information on types of oncologists plus tips on how to select the best oncologist for you. The site also provides information about specific drugs, a medical dictionary, and issues related to coping.


Association of Oncology Social Work (AOSW)

100 North 20th Street, 4th Floor
Philadelphia, PA 19103
(215) 599-6093
(215) 545-8107 (fax)
info@aosw.org
www.aosw.org
“The Association of Oncology Social Work (AOSW) is a nonprofit, international organization dedicated to the enhancement of psychosocial services to people with cancer and their families” (Web site). The organization is primarily a professional organization for oncology social workers; the Web site does provide information and links to resources that may be helpful to patients and their families.


CancerCare, Inc.

275 7th Avenue
New York, NY 10001
(212) 712-8400 (administration)
(212) 712-8080 (services)
(800) 813-HOPE (800-813-4673)
www.cancercare.org
“CancerCare is a national nonprofit organization that provides free, professional support services for anyone affected by cancer” (Web site). You may find the reliable online information very helpful and may choose to investigate the online and telephone support groups and lectures, in addition to the many other resources and services this organization provides. Much information is provided in Spanish as well as English, and counseling locations are currently available throughout the NY/NJ/CT tri-state area.


Cancer Legal Resource Center

919 Albany Street
Los Angeles, CA 90019-0015
(213) 736-1455
(866) THE-CLRC (866-843-2572)
www.lls.edu/academics/candp/clrc.html
“The Cancer Legal Resource Center provides free and confidential information and resources on cancer-related legal issues to people with cancer, their families, friends, employers, healthcare professionals, and others coping with cancer” (Web site). The Center is a joint program of Loyola Law School in California and has a national toll-free telephone assistance line where callers can receive
information about relevant laws and resources in both English ad Spanish.


CancerWise™

The University of Texas M. D. Anderson Cancer Center
1515 Holcombe Boulevard
Houston, TX 77030
(800) 392-1611 (USA)
(713) 792-6161
www.cancerwise.org
“CancerWise is a monthly electronic publication that contains information about the latest advancements in cancer treatment and research, support programs and activities, and cancer prevention tips, among other cancer news and information. CancerWise is produced by The University of Texas M. D. Anderson Cancer Center” (Web site). Contains featured articles and a “cancer newsline.”


Catholic Charities

66 Canal Center Plaza, Suite 600
Alexandria, VA 22314
(703) 549-1390
(703) 549-1656 (fax)
www.catholiccharitiesusa.org
One of the nation’s largest social service networks, serving people of all religious, social, or economic backgrounds. Emergency assistance for basic needs— mortgage and rent, utilities, food—may be available through local chapters, which can be located through their Web site locator.


Centers for Disease Control and Prevention (CDC)

1600 Clifton Road
Atlanta, GA 30333
(800) 311-3435
(404) 639-3534
www.cdc.gov
www.cdc.gov/cancer (Cancer Prevention and Control Information)
The CDC’s mission is “to promote health and quality of life by preventing and controlling disease, injury, and disability” (Web site). You can search for information on a wide range of medical topics, including cancer-specific issues. Much information is also provided in Spanish.


Department of Veterans Affairs

Veterans Health Association
810 Vermont Avenue, NW
Washington, DC 20420
(800) 827-1000 (local VA office)
(202) 273-5400 (Washington DC office)
www.va.gov
This site provides extensive information for veterans. It is a one-stop site for all concerns regarding veterans’ health benefits and services. Eligibility forms can be either downloaded or completed online.


empowering yourself with knowledge about eating clean, nutrition and your type of cancer, and by consulting a dietitian or nutritionist, you could change your life.

‘You are not only the patient but also the customer, you are paying for treatment and if
you are not feeling like you are being heard, if you have questions that are not being
answered or you don’t feel that the treatment is the right option for you, go and get a
second opinion.’ – NATHALIE MAT, DIETITIAN

For many of us, the word ‘cancer’ leaves us with an uneasy feeling. It brings
to mind death; our own or that of a loved. A million thoughts race through
our minds. Diet is unlikely to be one of them. And that is okay. These things
take time.

TAKING YOUR TIME


Dietitian Nathalie Mat explains that often cancer patients, or the parents of
children with cancer, need some time and space before undergoing further
counselling like a nutrition assessment. ‘The diagnosis can be such a shock
that one is too busy trying to process what the diagnosis means to hear
anything else being asked or said. It is very important that the healthcare
providers of cancer patients do not overload the patient with information in a
single session, as there is often too much information to get across in one
sitting,’ she says.

It is a frightening process, and so Mat advises first having your cancer put
into perspective by a health professional and asking as many questions as you
want. Sometimes you just need someone to tell you what to expect or what
treatment will be like. The health professional’s role is not only to help you
make decisions about your treatment, but also to help you with manageable,
realistic and feasible lifestyle changes, like dietary changes, tailored specifically
for you and your type of cancer.

Avoid Googling your type of cancer, however, as the information on the
Internet is often unreliable and incomplete. Rather consult different health
professionals, from your GP to your surgeon and oncologist. Mat
occasionally comes across patients who feel uncomfortable with their current
doctor, but who are afraid to do anything about it because of how serious
cancer can be. ‘At the end of the day, it is your body that is being treated by
doctors and surgeons, so you need to be comfortable with it. That sometimes
means taking a bit more time to understand treatment options and their
consequences, and getting informed so that you feel okay with each step. I
think it is an incredibly personal process.’

Support from loved ones makes a massive difference during treatment and
recovery. Mat advises loved ones to give cancer sufferers a lot of affection and
personal touch, as it can be a very isolating disease.

NUTRITION AS MEDICINE


Over a decade ago, South Africans were already looking at how food-based
dietary guidelines (FBDGs) could play a role in preventing and treating
disease. In 2001, an editorial in the South African Journal of Clinical Nutrition
stated: ‘South African nutritionists have an advocacy role in ensuring that
these FBDGs receive sufficient media and political exposure to be
incorporated into health policy. But they also have an educational role in
ensuring that all professionals in public health understand the potential of the
guidelines to help improve dietary intakes, nutritional status and health, and
in the prevention of diet-related diseases.’81

The concept of diet as a form of treatment is not new. We have all come
across the proverb, ‘an apple a day keeps the doctor away’, at some point in
our lives. Famed inventor Thomas Edison even once famously remarked:
‘The doctor of the future will no longer treat the human frame with drugs, but
rather will cure and prevent disease with nutrition.’

As we have seen, many factors contribute to illnesses like cancer, especially
in modern society. However, as knowledge and information around nutrition
becomes more prevalent, especially in the South African context, individuals
have more control and power over their own health and healing. If you are
not enamoured with the idea of going raw, vegetarian or vegan, the South
African FBDGs is a useful and beneficial starting point for adopting a
healthier way of eating:


  • Enjoy a variety of foods.
  • Be active.
  • Drink lots of clean, safe water.
  • Make starchy foods the basis of most meals.
  • Eat plenty of vegetables and fruit every day.
  • Chicken, fish, meat, milk or eggs can be eaten daily.
  • Eat fats sparingly.
  • Use salt sparingly.
  • Use foods and drinks containing sugar sparingly and not between meals.
  • If you drink alcohol, drink sensibly.



By using the tools available to you and empowering yourself with knowledge
about eating clean, nutrition and your type of cancer, and by consulting a
dietitian or nutritionist, you could change your life. As the ancient Greek
physician Hippocrates said, ‘Let food be thy medicine, thy medicine shall be
thy food.’

According to Cancer Research UK, cancer survival rates in the United
Kingdom have doubled in the last forty years. In fact, half of the people
diagnosed with cancer now survive the disease for at least five years.

Furthermore, almost three-quarters of children with cancer are now cured of
the disease, compared with around a quarter in the late 1960s.82
These kinds of statistics are not available for South Africa, but global
trends give a lot of hope. Cancer is no longer a death sentence. The studies
and research being conducted show an abundance of ways to take charge of
your disease and fight it.

Unfortunately, we will never really know why some people die from
cancer and others do not. Carrie Brown was a cancer sufferer who eventually
died, but not before putting up a good fight and making sure she left behind a
legacy in the form of her beautiful young son.

This book is part of her legacy too. My fond memories of Carrie have
given me the strength, hope and motivation to write a book that might
possibly provide some help and guidance to others like her when it comes to
eating well and nurturing the body. By including other people’s stories and a
few ideas about how to incorporate the most nutritional foods into your diet,
I hope that your journey is that much more wholesome – whether you are
aiming to prevent or treat cancer. Carrie believed that we were all put on earth
to serve a purpose. Not only did she serve many beautiful purposes
throughout her life, but she continues to do so in her afterlife.

Sunday, July 24, 2016

CANCER IS A CRUEL DISEASE

CANCER IS A CRUEL DISEASE

Hillcrest, tucked up on a hill in KwaZulu-Natal, has a slight chill in the air, even in summer. Mist rolls across the surfaces of roads and fills the valleys, driving residents deeper under their down duvets.

But I cannot imagine it was the weather that concerned the Browns that summer in 2011. Carrie, after undergoing another painful surgery, had been told there was nothing more the doctors could do for her. Her son had just turned five. Her sister-in-law Kerry, my very best friend from high school, busied herself with work as the realisation of death washed over her and left her numb. It was a difficult time for the whole family. Should they take time off work? How long might it be? Was this really the end? Sister Cherry Armstrong sat with Carrie as she lay in her bed suspended between life and death, her pale skin bearing no sign of the seven years of torture she had endured.

‘As a patient starts his or her journey of death, they are very aware of what is happening. Their skin is very pale, maybe bluish in colour. Everything lacks lustre, eyes can become sunken with no brightness,’ Sister Armstrong tells me. She has sat by the side of many cancer patients and held their hands as they have slipped into deathly sleep. She spends the time before consoling, advising, pacifying and helping them confront the fear and trauma of the experience. ‘Death is a profound human experience. As someone approaches death, their emotional and spiritual needs are as great, if not greater, than those of their body.’

I had known Carrie since my school days, when she returned from England with her husband, Kerry’s brother. They were high-school sweethearts and she often told us their love story. They had met at the ice rink in Durban as teenagers, got married in their early twenties and gone on to travel the world, eventually working in the UK. Her stories were intoxicating; we, in the adolescent stage of our lives, drank them in and made them our own. It was Carrie who advised us through our early, insignificant relationships. Her sense of humour, good-natured demeanour and compassion had me enthralled.

Tragedy struck soon after their return to South Africa, in 2004. A lump was found in Carrie’s breast. Not even a year later, Kerry’s boyfriend underwent treatment for testicular cancer. I wondered how much one family could bear. A lot, I would come to learn. Kerry stayed in KwaZulu-Natal as her family fought the dreaded disease that had invaded their lives, Carrie only ever on the cusp of recovery before tragedy would strike again. I went away to study, isolated by my newfound wonder of the world.

I got the call in early December 2011, while rushing off to interview someone for a magazine article. Carrie was gone. I put down the phone and drove to the appointment no longer caring how late I was. My throat was dry as I asked my questions and I barely heard the answers.

DEALING IN DEATH

How do you console a family who have spent years fighting demons? I didn’t know. The Browns had been in a war zone for so long and now it was all over. And yet there are so many others in our country, in our world, who are right now standing in that same war zone, fighting the same cruel disease.

The World Health Organization (WHO) reports that cancer is the leading cause of death worldwide, responsible for 7.6 million deaths in 2008 alone; and that worldwide deaths from cancer are rising. It estimates that 13.1 million people will die from the disease in 2030.1 Cancer’s prevalence, however, does nothing to quell the grief of those who have lost loved ones.

‘There is never a way to ease anyone’s pain. Everyone goes through their own journey of grief in their own way; you can just be there to listen and be honest with whatever questions they have,’ Sister Armstrong explains.

Carrie’s death was a tragedy that I struggled to come to terms with, for myself and her family.

Carrie and her husband had bravely decided during her battle with cancer to try to conceive a child before the inevitable hysterectomy. Their beautiful boy was born in November 2006. I asked Sister Armstrong what Carrie spoke about in her last few days and it was mostly her son. ‘Patients speak of their fear, their beliefs, their families, the people they are leaving behind and, as they near death, they often speak about the people they are seeing, the people who are close to them and these are always people who have died. I truly believe they have a link to the other side at this point,’ she tells me.

While death might bring with it some respite for the suffering cancer patient and his or her family, the effects are still devastating on those left  behind. The Browns are just one family in a sea of many to have their lives changed irreversibly by this disease. My uncle passed away from cancer in 2008. One of the youngest girls in the country to have been diagnosed with breast cancer at the age of eighteen attended my university. She passed away in 2012. Knowing someone who has lost someone to cancer is by no means rare. In America, one in eight women will develop invasive breast cancer over the course of her lifetime. According to Breastcancer.org, an estimated 230 480 new cases of invasive breast cancer were expected to be diagnosed in women in the US in 2011.2 While some resources suggest that death from cancer and cancer itself is decreasing ever so slightly, it is still prevalent enough for just about everyone to know someone who has had cancer.


TREATMENT AND DIET

According to the WHO: ‘Even with late stage cancer, the suffering of patients can be relieved with good palliative care.’

How though? As we’ll see, diet is one way. But the Internet is saturated with information and theories regarding what diets to follow to prevent cancer and which foods to avoid. There are stories about cancer patients who healed themselves by eating only grapes and research into how modern diets may or may not play a role in illness. You will be forgiven as a cancer patient or someone looking after a cancer patient for not knowing where to start. The resources are sporadic and varied, with medical practitioners often reluctant to give specific advice because of the varying opinions. They also do not want to discourage cancer patients from undergoing traditional cancer treatments like radiation, chemotherapy and surgery. Former Miss South Africa, journalist and radio broadcaster Monica Fairall, who died of myeloma in  2009, wrote in Challenge Cancer the Holistic Way (1999): ‘Deciding whether or not to receive conventional treatment is a matter of individual choice, but not too many doctors would be comfortable with the prospect of a cancer patient refusing all treatment. Doctors’ training gears them to take action with the tools they have at their disposal.’

While many doctors shy away from alternative forms of treatment, there are some that acknowledge the role of diet specifically. Dr Elizabeth Murray, a Cape Town-based breast cancer oncologist, says that she checks her patients’ vitamin D levels regularly, as well as her own. ‘I do not think there is any doubt that modern diet plays a role in cancer,’ she explains. ‘While the role of red meats and dietary fat in breast cancer development is uncertain, I think it is likely that it plays a role.’ It is because of this that Dr Murray refers many of her patients to a nutritionist or dietitian for an expertly guided, balanced diet to supplement treatment.

For Dr Murray, a crucial step for post-menopausal women to reduce their chances of breast cancer is to not become overweight and to limit or avoid alcohol and smoking. For her patients with breast cancer, she recommends that ‘they stick to low-fat dairy products, if they are going to use dairy products, and that they avoid too much soya, as this I believe has oestrogen in it. I also advise my patients to make sure they get enough vitamin D and calcium as they are supposed to play a role in breast cancer.’

This book does not aim to dispute the benefits of traditional cancer treatments, but rather takes a look at which dietary and lifestyle changes may assist with these treatments, and which could in fact influence cancer prevention.


KNOWLEDGE INTO PRACTICE

Kerry explains that even though diet came up as something to focus on when her boyfriend was diagnosed with cancer in 2005, nothing was done about it. ‘People that talk about other people getting cancer always bring up the fact that it’s because of hormones in all of our foods these days, and while I believe that it is a contributing factor, no one really does anything about it. Once he had recovered from cancer, he continued to eat fast food and his eating habits and lifestyle habits did not change.’

Similarly, she adds, during Carrie’s treatment the family tried their best to look up what lifestyle and dietary changes they could make to assist her treatment. They began ordering their chicken from an organic farm and were a bit more mindful of the nutritional value of their meals. ‘When she was first diagnosed, I think they tried to read up on what to eat and what not to do.

She stopped eating lettuce during her first chemo as doctors said it contained a lot of bacteria and germs that wouldn’t help her immune system. I think they really tried in the beginning.’ However, towards the end it became more of an attitude that, because she was going to die, she might as well enjoy what she could. ‘Right at the end she ate what she could stomach – Bovril toast, cheese and biscuits and nutritional milkshakes when she didn’t have an appetite.’

This is a common occurrence. Sister Armstrong says ‘patients tend not to eat as death nears, their bodies shut down and they don’t eat or drink. If they are still eating, it is normally a small piece of fruit or yoghurt but in tiny portions.’

So what are we to do? How do we ease pain and nausea for our family members and friends who are already suffering from this illness? How do we prepare meals for our loved ones that they will not only eat, but that will provide them with the nutrients they need? And will it make a difference? Are there resources out there that can assist us in making everyday groceryshopping decisions that could have a much bigger impact?

‘Do everything in moderation,’ Sister Armstrong suggests as a first step. ‘Never shock the body with a sudden complete change of lifestyle; too much or too little of anything is not good. Follow a healthy eating plan with a balance of all nutrients.’ She adds that Hospice provides a great platform for resources and advice in such matters, especially as they are trained in palliative care. Hospice South Africa describes palliative care in their mission statement: ‘To promote quality of life, dignity in death and support in bereavement for all living with a life-threatening illness.’

It is the body’s basic need for nutrients such as proteins, carbohydrates, fats, and certain vitamins and minerals that, says registered dietitian Catherine Boome, make diet so important during cancer treatment.

Confirming what Sister Armstrong told me, she explains, ‘Certain cancer therapies have side effects that may also affect the cancer patient’s ability to consume food. Some of the side effects include a decrease in appetite, nausea, vomiting, changes in taste and smell, and changes in bowel movements.

These effects put the patient at risk for developing malnutrition as a result of a lower intake of food.’ Cancer treatments like surgery, radiation and chemotherapy can also negatively affect how the body digests and uses foods, she says. ‘The patient is at risk of weight loss, as well as various nutrient deficiencies.’

By focusing on proper nutritional care during cancer treatment, the patient’s ability to maintain quality of life, manage nutrient deficiencies, avoid weight loss (especially muscle loss) and minimise the side effects of the various treatments is improved.

So how does one go about ensuring patients are getting the correct nutrition to meet their bodies’ needs? It is tough to find answers when so many theories from raw food diets to coffee enemas are circling the world. In desperation, many of us would try just about anything if it meant there was a chance for a cure. We will explore these ideas in-depth, and look at how nutrition and diet can play a role in both preventing cancer and assisting in its treatment, as well as how this can be practically integrated into daily life.

CARRIE ON TOMORROW

The mist continues to roll in and out of Hillcrest, and temperatures continue to rise and fall with the changing seasons. Carrie’s death echoes in the hills, her too-short life tattooed in the minds of those who knew her best. I hope that in her memory I can offer just a little something to those who suffer as she did and to their families who never leave their sides. In the following pages, you will find the stories of those who have been ill and those who have looked on, helplessly, as well as advice from experts in the fields of cancer and nutrition. This book aims to assist those dealing with cancer, by offering some guidelines and warm, comforting and compassionate advice from the very people who have dealt with what you are dealing with right now. Most importantly, this book aims to remind you that you are not alone. A tribute to the Browns and their strength, I wish everyone reading this the same courage.

‘Every life is a purpose; some purposes are completed before others.’ – CARRIE BROWN


Saturday, July 23, 2016

WHAT IS CANCER? WHAT CAUSES CANCER?

WHAT IS CANCER?

While cancer is often referred to as one illness, it is actually over a hundred different diseases. Many cancer cases are unique, and although there can be many different reasons for its development and many different ways it manifests itself, the way that cancer is formed is quite generic. According to the WHO: ‘Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumours and neoplasms. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. The process of the spread of cancer in the body is referred to as metastasis. Metastases are the major cause of death from cancer.’

Johannesburg-based dietitian Jenny Meyer points out that carcinogenesis, which is the origin or development of cancer, is a biological, multistage process that has three phases: initiation, promotion and progression. ‘A carcinogen is a physical, chemical or viral agent that induces cancer,’ she explains.

Initiation is when a cell’s DNA is changed so that the cell mutates. This change/mutation can either be spontaneous or triggered by a carcinogen. A single mutated cell is not dangerous and may simply die; however, it can lie dormant in the body for many years. During the promotion stage, the initiated mutated cell is stimulated to divide and reproduce many cells all with the same mutation. Like in initiation, the trigger can be natural or caused by a carcinogen. (Often initiators also act as promoters.) In the progression stage, the constant replicating mass of cells form tumours or invade the blood, like in the case of leukaemia. They then metastasize or spread from the primary tumour to other parts of the body, taking the place of normal tissue.  This is when secondary cancers are formed.

The American Cancer Society (ACS) explains that cancer starts when cells in a part of the body start to grow out of control, but cancer cell growth is different from normal cell growth. ‘Instead of dying, cancer cells continue to grow and form new, abnormal cells. Cancer cells can also invade (grow into) other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell.’

WHAT CAUSES CANCER?


While abnormal cell DNA may be passed on genetically, the majority of DNA damage is caused by mistakes that happen while the normal cell is reproducing or by something in the environment. Sometimes the cause is something obvious like cigarette smoking or sun exposure, but generally it is difficult to know exactly what causes any one person’s cancer.

However, the ACS reckons that ‘non-inherited factors have a larger impact on cancer risk for the population as a whole. Avoiding the use of tobacco products and exposure to second-hand smoke, maintaining a healthy weight, staying physically active throughout life, and consuming a healthy diet can substantially reduce a person’s lifetime risk of developing or dying from cancer.’9 Thus, being overweight, inactive and/or unhealthy can be the trigger that causes mutation or DNA damage, which could lead to cancer. Meyer elaborates: ‘Chemicals or carcinogens, such as polycyclic aromatic hydrocarbons (PAH), N-nitroso compounds (NOC) and bisphenol A (BP-A), limited fruit and vegetable consumption, radiation, tobacco/smoking, malignant neoplasm, viruses and excess energy all contribute to carcinogenesis. Nutrition may modify this process at any stage and with thousands of chemicals existing in a normal diet, some better known than others, diets can be both inhibitors and enhancers of carcinogenesis.’

The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) concur. Human adults are made up of around ten trillion cells, which are renewed and replaced constantly. ‘About 5–10 per cent of cancers result directly from inheriting genes associated with cancer, but the majority involve alterations or damage accumulated over time to the genetic material within cells. The causes of damage are both endogenous (internal) and exogenous (environmental). Food, nutrition, and physical activity are important environmental factors in the development of cancer.’

The University of Texas MD Anderson Cancer Center also identifies unhealthy diets, physical inactivity and obesity as risk factors for cancer, along with ageing, tobacco, familial/genetic risks, excessive UV exposure, cancer-associated viral/bacterial infections, chronic inflammation and various environmental exposures to things like radon or radiation.

Meyer cites modern diets, chemicals, hormones and a more sedentary lifestyle. ‘Evidence suggests that almost one-third [approximately 30 per cent] of cancer deaths may be attributed to nutrition and lifestyle behaviours such as poor diet, physical inactivity, alcohol use and obesity. Tobacco use results in a further significant increase in cancer deaths [another 30 per cent].’ She believes that an estimated 50 to 70 per cent of cancer deaths are potentially preventable by simply decreasing high-risk behaviours.

In looking at risk factors tied to cancer in her book, Monica Fairall singles out alcohol, diet and nutrition, environmental toxins, exercise, genetics, hormones, radiation, smoking and tobacco, stress and psychological factors, and viruses. While these are all important contributors to cancer, my focus is on the diet and nutrition aspects, although they are all interconnected. As Fairall points out, ‘Conservative estimates link over 30 per cent of cancers to nutritional causes. Some observers put the figures as high as 60 per cent among women’s cancers, and 40 per cent of men’s cancers.’ 11 These dietary risks, according to Fairall, include a high intake of animal fats, not enough fibre, smoked, pickled and salt-cured foods, chemically coloured foods, artificial sweeteners and a heavy intake of refined sugars.

While it may be overwhelming to engage with all the different ways to improve your health, it is important that you do so.

There is a wealth of biological evidence that shows how food and nutrition, physical activity and body composition have the ability to influence several stages in the process of cancer development. In a 2007 report, the WCRF and the AICR unequivocally stated: ‘Nutrients and food constituents have effects that can either inhibit several events that lead to cancer or contribute to cancer development, by altering DNA itself, or by altering how the genetic message in DNA is translated. Physical activity and variations in body composition also appear to influence cancer risk. Indeed, overall dietary patterns can indirectly influence cell growth by way of changes in general metabolic, regulatory, and endocrine effects.’

INTRODUCTION Clean Food for Cancer

INTRODUCTION Clean Food for Cancer


A CLEAN LIFE, A CLEAN BODY

There is an undeniable link between nutrition and cancer. The aim of this book is to not only investigate this link, but also to show you how diet and a ‘clean’ way of eating can contribute to both the prevention and treatment of cancer. You will find comments from dietitians, raw food experts and those in the meat industry, as well as statistics from some of the world’s leading cancer research institutions. In time, you will see that it all comes down to a simple truth: you cannot get healthy without eating healthy. If you put rubbish into your body, your body will in turn become rubbish. If you put wholesome, healthy and nutritional food into your body, your body will be wholesome, healthy and nourished.

Eating ‘clean’ means following a diet that ensures only the best and most healthy foods, like fresh fruits and vegetables, go into your body. It also means avoiding things that are not as clean, like refined sugars, snacks laden with salt, and trans-fats. There are many different ways to eat clean, which are outlined in the following chapters and are accompanied by personal stories from those who have either had cancer or have been through it with a loved one. My hope is that this information will firstly help you decide for yourself the impact clean eating can have on the prevention and treatment of cancer, as well as general health and well-being, and secondly show you how to go about it.

Good nutrition is vital for everyday living and even more so for people dealing with a life-threatening illness. The bottom line is that by eating clean, you can change your life.

How to CANCER PREVENTION

‘To keep the body in good health is a duty … otherwise we shall not be able to keep our mind strong and clear.’ – BUDDHA


The WHO believes that over 30 per cent of cancers are actually preventable
and that, regardless of resource levels, all countries can implement the four
basic components of cancer control – prevention, early detection, diagnosis
and treatment, and palliative care – and thus avoid and/or cure many
cancers.76 We have already seen that by educating ourselves and ensuring
regular check-ups, early detection is possible. And diagnosis, treatment and
palliative care are sectors that are well established in South Africa. But what
about prevention?

The WHO suggests that cancer prevention starts with not using tobacco,
following a healthy diet, being physically active and moderating the use of
alcohol. According to The China Study, in which T. Colin Campbell and
Thomas M. Campbell II present their intensive research into the link between
diet and common illnesses like cancer, diabetes and heart disease, asserts that
plant-based diets have been scientifically proven to benefit human beings
around the world. This research is significant, considering that the ACS
recommends individuals consume a healthy diet with an emphasis on plant
foods, limiting their consumption of processed meat and red meat.77

What can we conclude from this? Obviously, maintaining a balanced
lifestyle and a healthy way of eating, where one includes as many fruits and
vegetables as possible, is logically a better way to live, lowering your chances
of developing all sorts of diseases as well as ensuring your dietary intake is
made up of a lot of vitamins and nutrients. With smoking responsible for 22
per cent of cancer deaths in the world,78 it is also fair to suggest that cutting
back on habits such as this is a good idea.

We are taught about food pyramids at school and reminded by our
parents to eat our vegetables, but how often do we significantly factor this
information into our daily lives? My friend Kerry, who has witnessed
firsthand how a person’s body can deteriorate says, ‘I always thought that I
could eat what I wanted to a certain degree because I danced a lot and played
sport at school. I met someone in 2008, however, who introduced me to gym
and showed me how eating clean could change your body and how you felt. It
was during this period that I started to understand how your body reacts to
things that you put in it. For example, after eating clean for a while and then
eating gluten or having lots of sugar, I could feel how my body would disagree
with it and how it could even alter my mood.’ While Kerry would not call
herself a fanatic, she now reads labels and stays away from breads, sugars and
processed foods. ‘I started thinking more about what I put in my mouth. I
now understand that your body is a machine and you need to feed it the right
foods to keep it working well. I think I always knew the basics of healthy
eating, but I only chose to enforce them a couple of years ago.’

The WCRF and AICR’s Food, Nutrition, Physical Activity, and the Prevention
of Cancer: A Global Perspective, concludes that, while smoking, exposure to
tobacco, infection, infestation, solar radiation, food and nutrition, physical
activity, body composition, and various other factors are all causes of cancer,
‘food and nutrition, and physical activity can protect against cancer.’79 Ergo,
we can choose ways of living that will protect both ourselves and the next
generation from getting cancer.

The same report summarises the most common types of cancer and lists
foods that research indicates may help protect one from getting that particular
cancer:

Bladder cancer  ==>> milk

Cancer of the mouth, pharynx, and larynx  ==>> non-starchy vegetables, fruit and foods containing carotenoids

Cervical cancer  ==>> carrots

Colorectal cancer  ==>> Foods containing dietary fibre, folate, vitamin D, selenium and calcium, garlic, milk, non-starchy vegetables, fruit and fish

Endometrial cancer  ==>> non-starchy vegetables

Kidney cancer  ==>>  fruit and vegetables rich in antioxidants and phytates

Liver cancer  = =>> fruit

Lung cancer  ==>> non-starchy vegetables, fruit, and foods containing selenium, quercetin and carotenoids

Nasopharyngeal cancer  ==>>  non-starchy vegetables and fruit

Oesophageal cancer  ==>>  non-starchy vegetables, fruit and foods containing beta-carotene, vitamin C, dietary fibre, folate, pyridoxine and/or vitamin E

Ovarian cancer  ==>>  non-starchy vegetables

Pancreatic cancer  ==>>  fruit and foods containing folate

Prostate cancer  = =>> pulses (legumes), including soya and soya products, and foods containing vitamin E, lycopene and selenium

Skin cancer  = =>> foods containing retinol (vitamin A)

Stomach cancer  = =>> non-starchy vegetables, specifically allium vegetables, as well as fruit, pulses (legumes), soya and soya products, and foods containing selenium

Breast cancer is an interesting case. Instead of specific foods, the report cites
‘life events’ that protect against breast cancer. These include late menarche,
early pregnancy, bearing children and early menopause, all of which have the
effect of reducing the number of menstrual cycles and therefore lifetime
exposure to oestrogen. The reverse also applies. Furthermore, there is
evidence that lactation and exercise protect against breast cancer at all ages. In
any event, the report recommends taking into account factors that modify the
risks of body and abdominal fatness, including physical activity, the energy
density of foods and drinks, and breastfeeding. This last point applies to
prevention of all forms of cancer.

EAT TO LIVE

While science strives to come up with the hard evidence, we would do well to
consider the role of our diet in cancer prevention. Obesity and unhealthy
eating are signs of an ‘unclean’ life, and are thus bound to have an effect on
cancer initiation and promotion.

‘Diet is a really important component of cancer prevention,’ says dietitian
Nathalie Mat. ‘Eating too much food is the primary reason people are
overweight and this is a direct consequence of diet. Being overweight
generally increases your risk of developing cancer. One’s diet can [therefore]
increase your risk of getting cancer. For example, a diet high in red meats and
low in dietary fibre increases your risk of developing cancer. High alcohol
intake increases your risk of certain cancers, especially the cancers of the
upper gastro-intestinal tract.’

Ernest Hawk, from the University of Texas MD Anderson Cancer Center,
maintains that the risk of cancer can be eliminated through proper nutrition,
physical activity and maintaining a healthy weight across your lifespan. ‘We
know what to recommend in broad terms for most people in the population,
but not always the specifics of a highly tailored or personalised “prescription”
for every individual.’ In other words, while ongoing research suggests that
dietary choices and physical activity do have a significant impact on
treatment and survivorship in terms of improving quality of life and overall
health, as well as diminishing side effects and symptoms, scientists are not
able to provide a general one-size-fits-all diet and accompanying ‘rules’ for
eliminating cancer risks. Hawk explains: ‘Diets are extremely varied and
complex within and across individuals especially over time. The vast variety
of different types of cancers and important cancer-associated outcomes also
create a challenge. Therefore, current recommendations are relatively broad
and apply to the general public.’ As we have seen, the broad
recommendations include increasing fruit and vegetables to at least five
servings a day, increasing whole grains, limiting red or processed meats and
salt, balancing calorie intake with expenditure to maintain a healthy weight,
and doing at least fifteen minutes of vigorous physical activity or thirty
minutes of moderate-intensity exercise per day at least five times a week.

While these may be general suggestions, Hawk says the point is that we do
know how to reduce the risk of cancer by at least 50 per cent today – by
adopting healthy lifestyles, having the recommended vaccines and undergoing
the recommended evidence-based screening tests.

AVOIDING CANCER

Cancer is an unforgiving disease that often takes its time breaking down our
health and our bodies. Recovery can be a very long process. The fear of
getting sick, of facing a premature death, is something that haunts many of us.

This fear can be so consuming that it can even provoke an individual to go
to extreme lengths to avoid cancer’s wrath. Allison Gilbert is one of many
who have undergone preventative surgery to lower their chances of getting
cancer.

‘I’m not a helicopter parent and my children would tell you I don’t bake
cupcakes for their birthday parties. But I’d readily cut off my breasts for them
– and recently I did,’ says Allison, the author of Parentless Parents, Always Too
Soon and Covering Catastrophe, who has been featured on CNN and a range of
other news stations and websites.

The double mastectomy, which she had done in 2012, took eleven-and-ahalf
hours and she does not regret a second, despite the long road to recovery.
She went on to have new breasts made out of her stomach fat so that she
would not have to get implants.

‘The decision to have surgery without having cancer wasn’t easy, but it
seemed logical to me. My mother, aunt and grandmother have all died from
breast or ovarian cancer and I tested positive for the breast cancer gene. Being
BRCA positive means a woman’s chance of developing breast and ovarian
cancer is substantially elevated.’

When weighing up the statistics, Allison learnt that patients with BRCA1
or BRCA1 mutations have a 50 to 85 per cent lifetime risk of developing
breast cancer, where the rest of the population only has a risk of around 13 per
cent. She also found out that the gene means a 60 per cent chance of ovarian
cancer. ‘At my gynaecologist’s urging, I tackled the threat of ovarian cancer
first. Because the disease is hard to detect, so often fatal, my ovaries were
removed in 2007, a few years after my husband and I decided we were done
having kids.’

It was not an easy decision and she had to deal with the repercussions,
including going through menopause at the age of thirty-seven. Less than a
year later, her aunt was diagnosed with breast cancer and died within four
months. ‘Aunt Ronnie’s death set me on a preventative mastectomy warpath.

I had already been under high-risk surveillance for more than a decade, being
examined annually by a leading breast specialist and alternating between
mammograms, breast MRIs and sonograms every three months, but suddenly
being on watch didn’t seem enough and I began researching surgical options.’

It was a concept that she thought about over many years, torn between the
anxiety of surgery and the threat of cancer. She eventually underwent the
double mastectomy on 7 August 2012, but it had been a stressful journey
getting to that point. ‘The worst moment came one night when my husband
and I were in bed. I began to cry uncontrollably and wished I could talk with
my mother and aunt about which procedure to have, which doctor I should
choose and whether I should even have the surgery. Then a moment of
bittersweet grace clarified what I needed to do. It struck me that the reason I
couldn’t speak to my mother and aunt was exactly the reason why I had to
have the surgery.’

Allison is convinced that if she had not had the surgery, she would have
been one of the estimated 226 000 women that according to the ACS are
diagnosed with invasive breast cancer each year. ‘I could have tried to eat my
way to a cancer-free life, but even Dr T. Colin Campbell, author of the
popular vegetables-are-key-to-health book The China Study admits diet may
not be enough to protect BRCA patients from cancer.’

Her rationale by the time she came to have the surgery was simple. She
was not willing to bank on a future miracle cure or drugs, or even statistical
evidence, that her lifestyle choices may help lower her risks. ‘Every surgery
substitute seemed locked in hope, not statistics. And as I’ve told my husband
and children, I wasn’t willing to wait. I love them more than my chest.’

TAKING CONTROL

Allison and others like her have taken extreme measures. You must do what is
right for you. Taking control of your health is a good first step, and maybe
the only step you will need to take. Nutrition can provide a valuable basis for
good health, but you need to adopt healthy habits in every aspect of your life.

Cutting down your alcohol intake, monitoring your stress levels, quitting
smoking, protecting yourself in the sun and ensuring that you get the right
amount of exercise all play a crucial role in protecting yourself against illness.
For a start, try to focus on the following:

  • Body fat – Be as lean as possible within the normal range of body weight.
  • Physical activity – Be physically active as part of everyday life.
  • Foods and drinks that promote weight gain – Limit consumption of energy-dense foods and avoid sugary drinks.
  • Plant foods – Eat mostly foods of plant origin.
  • Animal foods – Limit intake of red meats and avoid processed meats.
  • Alcoholic drinks – Limit alcoholic drinks.
  • Preservation, processing and preparation – Limit consumption of salt, and avoid mouldy cereals (grains) or pulses (legumes).
  • Dietary supplements – Aim to meet nutritional needs through diet alone.


AND REMEMBER: PREVENTION IS ALWAYS BETTER THAN CURE.