Folic Acid (Folate)

Higher intake of folic acid is associated with lower risk of colon and breast cancer, particularly in individuals who possess specific polymorphisms like the C677T polymorphism in methylenetetrahydrofolate reductase (30-60% of the population). This is due to the role folate plays in methyl donation in the body. Methylation defects, caused by folate and other methyl donor insufficiency, are thought to underlie colon cancer, and some studies show promise of administration of folate, and correction of methylation defects in colorectal cancer.[58] Note that folic acid is contra-indicated during treatment with the chemotherapy drug 5-FU. During this time, use other methyl donors, such as SAMe.

Vitamin A and Carotenoids

In the Colorectal Cancer Study at the University of Modena, 255 subjects with a history of colonic adenoma were randomized to receive treatment with either (1) vitamin A (axerophthol palmitate, 30,000 IU per day), vitamin C (1 gram per day), and vitamin E (d,l-alpha-tocopheryl acetate, 70 mg per day); (2) lactulose; or (3) placebo for an average of 18 months.46 At the end of the treatment period, adenoma recurrence had occurred in 5.7 percent of the antioxidant vitamin group compared to 35.9 percent of the placebo group (p<0.001).[59]

The integrity of the intestinal mucosa depends not only on the state of the immune system, the GALT and MALT, but also on the nutritional status and vitality of the rapidly turning epithelial tissue. As Dr Butterworth reminded us, this tissue needs to be replaced every few days. Regeneration of this tissue is highly dependent on nutritional status of the parent cells. Insufficiencies of vitamin A, folic acid, B12, and B6 can result in imperfections in cellular regulation and dysplasia. Vitamin A plays an important role in cell differentiation and cell turnover. This may explain why individuals who have colorectal polyps and certain types of dysplastic gut mucosa are found to have low levels of serum vitamin A and the carotenoid zeaxanthin.

This was addressed in a recent study published in the European Journal of Gastroenterology and Hepatology. The authors found a very close inverse correlation between the serum level of vitamin A and colorectal polyps.[60] Colorectal polyps are associated statistically with increased colonic cancer risk. One might say that low levels of intake and absorption of vitamin A and carotenoids may be associated with increased dysplasia of the gut mucosa and increased risk of colon carcinogenesis. JL Schwartz from Harvard shows that high doses of beta carotene will cause a reprogramming of the mutant p53 gene back to the normal p53 gene. It actually reverses from the mutant form that triggered cancer to the cancer-protective gene. Other studies have shown that high doses of carrot juice – for example, 11 oz of carrot juice a day – will decrease chromosome breakage by a third.

Changing to a diet with a lot of phytochemicals and brassica vegetables is also important. Phytochemicals, such as glucosinolates and nutrients in brassica vegetables help the body to detoxify. For instance, just changing two vegetables a day to brassicas increases the metabolism of Tylenol by seventeen percent. We have tremendous power over our genes and our detoxification ability by just with what we put in our mouths.

Vitamin C (ascorbate / ascorbic acid) and Colon Cancer

The theoretical concern of antioxidant use concurrently during chemotherapy lies in the knowledge that many current clinical oncology drugs induce cellular toxicity and death through mechanisms of intracellular free radical generation and it is thought that antioxidants may block this action. In the September 1999 issue of The Journal of Oncology an article appeared in which the authors discuss possible theoretical negative interactions of cancer chemotherapy drugs and concurrent use of antioxidants.[61] The experimental evidence for such a hypothesis is lacking and, in the majority of cases, shows the opposite. There are only three presently known examples in which any agent classifiable as an antioxidant has been shown to decrease effectiveness of radiation or chemotherapy in vivo, none of which apply to Vitamin C.[62] Vitamin C has been shown in either animal or human studies to either increase the efficacy and/or decrease the toxicity of the following chemotherapeutic agents: alkylating agents (cyclophosphamide, ifosfamide, busul phan, melphan), anti-biotic type agents (doxorubicin (adriamycin), bleomycin, epirubicin, daunorubicin), anti-metabolites (5-Fluorouracil, methotrexate), platinum compounds (cisplatin), radiotherapy, hormone therapies (tamoxifen), and plant alkaloids (etoposide, vincristine, paclitaxel).[63] For further review, the reader is referred to the study by Lamson and Brignall, Alternative Medicine Review, April 2000.

The ideal agent to treat cancer would be cytotoxic to tumour cells, but non-toxic to normal cells. Vitamin C has long been known to fulfil these requirements but is obscured, ridiculed and criticized by conventional medicine in favour of more powerful and toxic chemotherapeutic agents.[64]

Colonic polyps are recognized as frequent precursors to colorectal cancer. In a group of 36 patients with polyps, 19 received 3 grams ascorbate daily and 17 received placebo. The researchers noted a decrease in polyp area after nine months of treatment with ascorbate but not placebo. In addition, a trend toward decrease in polyp number was noted.[65] Other researchers have used antioxidants to prevent recurrence of polyps in patients who had undergone surgical removal of their polyps.

Clinical data demonstrates that ascorbic acid potentiates chemotherapy effects. However, there are still theoretical concerns from conventional oncology questioning the use of antioxidants, such as Vitamin C concurrently with chemotherapy.[66-69] The majority of clinical evidence indicates the usefulness of anti-oxidants, like Vitamin C, concurrently with most types of chemotherapy.[70, 71] In a recent review paper in The Journal of American Nutraceutical Association, Block and Evans reviewed all English articles listed in Index Medicus between the years 1990-2000 related to antioxidant and interactions with anticancer drugs or radiation and concluded, "…there is a rational basis for the continued use of antioxidant agents as a therapeutic adjunct in cancer therapy."[72]

Vitamin C has been extensively tested in vitro and in vivo for its ability to prevent the adverse effects of, decrease resistance to, and increase the effects of chemotherapeutic agents.[73] Combined administration of Vitamin C (1g/kg) and Vitamin K, given prior to chemotherapy, increased survival and enhanced the effect of several chemotherapeutic agents in a murine ascitic liver tumour model.[74] The vitamin combination did not increase the toxicity of these agents to healthy tissue. Splenic and thymic weights of the vitamin-treated animals were higher than those receiving cytotoxic treatment alone, suggesting an immune stimulating action of these vitamins. As well as being safe to use concurrently with chemotherapeutic agents, Vitamin C has also proved safe to be used concurrently with radiation. Vitamin C has been shown to have a radio-protective effect on normal cells while concurrently having a radio-sensitizing effect on malignant ones.[75,76]

Vitamin D3

Numerous studies have shown Vitamin D to be associated with a lower incidence of cancers, and colon cancer. The mechanism of Vitamin D's association with a lower colon cancer risk was not understood until recently, when it was discovered that laboratory animals given doses of vitamin D and then given lithocholic acid do not get colon cancer. It was also discovered that colon cancer patients have a high incidence of lithocholic acid. David Mangelsdorf, Professor of Pharmacology and a Researcher at the Howard Hughes Medical Institute at the University of Texas Southwestern in Dallas, recently published findings in the Journal Science that Vitamin D helps the body to break down lithocholic acid. Recent evidence suggests colon cancer may largely be caused by bile acid produced to help digest fat, specifically lithocholic acid. Lithocholic acid occurs naturally and can be broken down by the body. However, a high fat diet and dysbiosis (alterations in gut ecology) may allow the accumulation of lithocholic acid, which acts as an oxidant, irritant, mutagen and procarcinogens.

Calcium and Vitamin D are synergistic minerals, and taking too much of either can throw off the balance of the other. Vitamin D should be taken with calcium, which has also been shown to have benefit in colon cancer. Supplementation with 1200 mg of calcium (as calcium carbonate) for four years was associated with a significant, 15-percent reduction in the risk of adenoma recurrence (p=0.03).48 In this double-blind trial (n=832), the average number of adenomas seen in calcium-supplemented patients was 24% lower than in those taking placebo (p=0.02).[77]

Selenium

The mineral and micronutrient selenium has shown benefit in preventing and treating cancer and colon cancer. Observational and experimental studies have suggested that dietary supplementation with selenium can inhibit the development of colon cancer.[78] Patients with colon cancer have been shown to have decreased levels of selenium in their diet and tissues.[79] A landmark study found significant reductions in certain cancer incidence among individuals using 200mcg of selenium supplementation for more than four years. Researchers at the University of Arizona found that people who took the selenium supplements versus those that took a placebo, had 63% fewer cases of prostate cancer, 58% fewer colon and rectal cancers, and 45% fewer lung cancers. Furthermore, the selenium group suffered 50% fewer cancer deaths over all than the placebo group.[80]

Summary

Abraham Hoffer, who has seen over 970 patients suffering from cancer in the last 20 years, has concluded that, "…the optimum treatment for cancer today is a combination of xenobiotic and orthomolecular (high dose vitamin) therapy and that the treatment must be started as soon as possible." Hoffer's view is that orthomolecular treatment improves the quality of life, decreases side effects and is palatable. Furthermore, he states, "There can be no logical reason today why most of the research funds should go only toward the examination of more chemotherapy and more ways of giving radiation. There must be a major expansion into the use of orthomolecular therapy to sort out the variables and to determine how to improve the therapeutic outcome of treatment. "Furthermore, conventional and alternative medicine both need to scrutinize their own treatments and consider that by working together and integrating sound, rational approaches from both camps.

References

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Further Information

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Editors Note

This is the final part of Dr Calvino's splendid treatise regarding Nutritional Treatment approaches to Colon Cancer. We thank him for this most forward looking and insightful contribution to our knowledge and understanding.