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Preventing Degenerative Disease
- Cancer Prevention
- Cancer and Nutrition
Dr. Strands Supplement Recomendations for those with this medical issue:
It is hard to give a simple formula for all the various cancers. But if there is no evidence of the cancer spreading (or the surgeon believes he totally removed it), I will add 200 mg each of grape-
. If the patient has metastatic cancer (cancer that's spread), l will recommend 300 mg of grape-seed extract along with 500-600 mg of CoQ10
. Children ages 8 to 15 should take only half of the recommended levels on Table 1
and half of the grape seed extract and CoQ10
recommended here.Pharmaceutical Grade Supplements
Cancer and its Causes
Doesn't it seem that just about anything we do or eat these days allegedly causes cancer? Excessive exposure to sunlight increases the risk of skin cancer. Asbestos workers have increased risk of developing an unusual form of lung cancer called mesothelioma. Smoking and secondary smoke are the main reasons lung cancer is the leading cause of cancer deaths. Radiation, charcoal steaks, too much fat in our diet, saccharin, and the many other chemicals found in herbicides and pesticides are what medical literature refers to as carcinogens, or those things that increase our risk of developing cancer.
Since the first report that chimney sweeps had an increased risk of scrotal cancer because of their exposure to soot, we have become more and more afraid of our environment, and rightfully so. As I mentioned earlier, our bodies face exposure to far more chemicals than any previous generations did. And what is the one common denominator all of these carcinogens have? You guessed it. They all increase oxidative stress. Here lies the key to understanding new strategies for fighting cancer.
Oxidative Stress as the Cause of Cancer
Many researchers have offered theories as to what is the underlying cause of cancer. Unfortunately, not one of these theories has been able to explain the completely diverse aspects of cancer and the development of the disease within the human body
In response to this medical conundrum, Dr. Peter Kovacic authored a comprehensive review in Current Medicinal Chemistry 2001. There he stated, Of the numerous theories that have been advanced, oxidative stress is the most comprehensive, and it has stood the test of time. It can rationalize and correlate most aspects associated with carcinogenesis (development of cancer)."
Kovacic's research supports growing medical evidence that when excessive free radicals are allowed to exist near the nucleus of the cell, significant damage to the DNA of the cell can result. The DNA of the nucleus is especially vulnerable when a cell is dividing, during which time the DNA strand is literally unwound and stretched out. Researchers are now able to confirm not only that free radicals can damage the DNA nucleus of a cell, but also which strands of the DNA they damage most frequently.
When met with an onslaught of carcinogens, the body's MASH unit will be busy trying to repair the damaged DNA. But in times of heavy oxidative stress. free-radical damage overwhelms the repair system and can lead to mutation of the DNA. Free radicals can also wreak damage on the genetic structure of the DNA, which can then lead to abnormal growth of the cell. As these cells continue to replicate, this mutated DNA is carried to each newly developed cell. When there is further oxidative stress to this mutated DNA of the cell, more damage occurs. The cell will then begin to grow out of control and take on a life of its own. It develops the ability to spread from one part of the body to another (metastasis), thus becoming a true cancer (Figure I).
A Multistage Process
Dr. Donald Malins, a biochemist from Seattle, reported a new method for identifying structural changes in the DNA of breast tissue. By using an instrument that bounces infrared radiation off the DNA and by analyzing the signals via a sophisticated computer, he is able to follow the structural damage to the DNA caused by free radicals.5
Researchers agree with Malins that the development of cancer is a multistage process that usually takes decades to develop. In adults cancer may take twenty or even thirty years to develop from the initial mutation of the DNA to its full-blown manifestation. In children this process may progress more quickly because of their more rapid cell turnover.6
Malins noted significant changes within the structure of the DNA as he followed it from normal breast tissue to metastatic breast cancer in all its developmental stages. Dr. Malins believed oxidative stress was the cause of this predictable damage to the DNA, which eventually led to the formation of breast cancer. He further argued that cancer was not so much the result of dysfunctional genes as it was the result of genetic damage that highly reactive free radicals caused.
For the past twenty-five years, researchers have believed that abnormal genes are the driving force behind all cancers. But now researchers are beginning to believe instead that individuals with certain genes are simply more vulnerable to oxidative stress than others. This may explain the familial patterns of many types of cancer.8
A Decade Late and a Dollar Short
Physicians usually diagnose cancer in the last stages of its development. Unfortunately, by the time a cancer is advanced enough to cause symptoms or to show up on an x-ray, it has usually been developing for more than ten to twenty years. Doctors get out the big guns of aggressive surgery, chemotherapy, and radiation only to realize that most often they can do little to help the patient.
The last time I diagnosed lung cancer in one of my patients, his oncologist recommended chemotherapy, a procedure through which the physician claimed he could bring the lung cancer into remission about 40 percent of the time. My patient was somewhat encouraged by the statistics until he asked just exactly what was meant by "remission." The oncologist answered, "If the cancer is successfully brought into remission, your life can be extended by about three months." Needless to say, this was not what my patient had hoped to hear. This is the typical, tragic story for most people with cancer.
When my own mother was diagnosed with a high-grade brain tumor, the radiation therapist said there was about a 1 percent chance that therapy could prolong her life. Against my wishes, Mother went through the treatments. She died six months later after battling not only the cancer but also the treatments that left her weak and ill. An aggressive treatment may extend a life a few months to even a year or so longer, but the suffering our patients and loved ones must endure for the marginal benefits seems a cruelty to those whose lives are already so fragile.
We're presently losing the battle against cancer. Is there any doubt that this malignant disease must be attacked at much earlier stages in its development before the number of deaths will decrease' We do have hope, you know. Understanding the role of oxidative stress in the development of cancer offers us a host of new possibilities in prevention and treatment.
Prevention of Cancer
As we begin to understand the root cause of cancer, therapeutic options become available. Since cancer is a multistage process that takes years to develop, numerous opportunities arise to intervene in this process.
In the earliest stages of cancer, we see changes primarily within the DNA nucleus itself. The mutations that occur via the free-radical attack of the DNA pass to each subsequent cell as it replicates. Eventually, because of further free-radical damage to the cell, a precancerous tumor develops. This is the first practical level that we can evaluate clinically. The final stage is the development of a frank malignancy or cancer, which has the ability to spread from one part of the body to another.
Differing from attacking cancer with treatments in its final stages, chemoprevention focuses on preventing the cancer from developing in its earliest stages. Remember, balance is the key. If we have enough antioxidants available, oxidative stress does not occur and the DNA of the nucleus is safe from initial damage. Imagine again the metaphor of the fireplace. When a screen is in place, cinders cannot pop out onto the carpet.
Chemoprevention also aims to reverse the damage that has already occurred to the cell. As you learned in Chapter 4, the body has the amazing ability to heal itself (remember the MASH unit). Let us now carefully consider a strategy for fighting off cancer in three planned phases of chemoprevention, and the effects each has on the body.
Chemoprevention Phase 1: Decreasing the Risk
The first strategy in the prevention of cancer may seem obvious: whenever possible, eliminate (or at least decrease) the exposure to carcinogens (chemicals that we know increase our risk of cancer). Though seemingly obvious, this phase is much easier said than done. Here are steps you should take immediately to decrease your risk of cancer:
1. Stop Smoking! Cigarette smoke is the most potent carcinogen to which many of us are exposed. Though nicotine is terribly addictive, we must struggle to rid the body of it and all the carcinogens contained in cigarette smoke. Smokers show a tremendous increase in the number of free radicals in their bodies.9 And though to a lesser extent, secondary smoke is also an important factor in oxidative stress.'°
2. Reduce Your Exposure to Sunlight. UVA and UVB ultraviolet light is a well-known carcinogen. I strongly recommend using sunscreen that protects against both. It's a discipline you can't live without. Parents, protect your children.
3. Eat a Low-Fat Diet. Excessive fat intake at meals is known to induce oxidative stress, especially when adequate amounts of antioxidants are missing in that meal. We must decrease saturated-fat intake, making certain we consume at least seven servings of fruits and vegetables and more than thirty-five grams of fiber each day. (I know you have heard all this before; but less than 9 percent of the population follows this advice!)"
4. Be Aware of Other Carcinogens. Whenever possible, choose to take action in decreasing your exposure to cancer-causing agents such as radiation, pesticides, herbicides, asbestos, charcoal, soot, and so on by purging them from your home environment.
A principle you will learn to appreciate is that if we reduce our exposure to all of these carcinogens, we will produce fewer free radicals for our body to fight. For example, it's difficult for me to recommend eating a healthy diet supplemented with nutritional medicine to a patient who is smoking two packs of cigarettes a day. I know the effect will be minimal at best; and unless he stops smoking, chances of decreasing the risk of cancer are definitely compromised.
Chemoprevention Phase II: - Maximize the Body's Antioxidant and Immune System
It is not possible to avoid exposure to all the carcinogens and chemicals in the environment. We must still live in this world. Hesitating with fear of "what might be out there" will only rob us of a full and abundant life. As you have already learned, the mere fact that we need oxygen to live puts us at a significant risk for oxidative stress. Therefore, the best strategy is not to hide out, but to maximize your own body's immune system and antioxidant defenses. And this begins by eating a healthy diet.
It seems logical that if oxidative stress is indeed the cause of cancer, antioxidants used to bring free radicals back into balance would lower the risk of cancer. This logic proves true. Cancer research specialist Dr. Gladys Block followed this precise logic while reviewing 172 epidemiological studies from around the world on diet and cancer. Dr. Block discovered a universal and consistent finding: those individuals who had the highest intake of fruits and vegetables (the main source of antioxidants) showed a significantly decreased risk of developing almost every kind of cancer. The risk of developing most cancers was two to three times less for those who had the highest intake of fruits and vegetables compared to those who had the lowest.12
The opposite also holds true. Dr. Bruce Ames, a leading cancer researcher stated in an interview with the Journal of the American Medical Association that individuals who consume the least amounts of fruits and vegetables have twice the risk of cancer as those who consume more.13
Merely by consuming five to seven servings of fruits and vegetables daily, we can decrease the risk of almost every type of cancer by half. 14
The absolute best defense your body has is a good diet. Nothing a doctor can prescribe will take the place of the diet your body needs to fuel and replenish itself. One of the principles you will hear me stress over and over is the fact that if you choose to use nutritional supplements, you must supplement a good diet, not a bad one. The first step toward building a strong immune system is to eat a high-fiber, low-fat diet largely made up of fruits and vegetables.
But we need more to practice chemoprevention. Medical research is beginning to demonstrate that taking antioxidants in supplementation to our diet is very important in chemoprevention. Studies show that supplementation of a good diet over a twenty-week period of time with vitamin C, vitamin E, and beta-carotene resulted in a significant decrease of the oxidative damage to the DNA of both smokers and nonsmokers. Vitamin E has also been shown to protect against exercise-induced DNA damage.4
Chemoprerention Phase III. Impowering the Body's Repair System
In Phase I and Phase II of chemoprevention, we were primarily concerned with decreasing the amount of oxidative stress the body has to handle and providing adequate antioxidants to prevent such stress to the DNA of the cell. In Phase III we will focus on the body's amazing repair system when coupled with adequate nutrients enabling the cell to repair significant damage that has already occurred.
Precancerous lesions or growths offer us a unique insight into the use of antioxidants in chemoprevention. It is difficult to follow these tumors within the body, but many studies have followed such tumors on the surface of the body. Such studies primarily look at leukoplakia, which is a precancerous tumor found inside the mouths of tobacco chewers, and cervical dysplasia, the precancerous tumor on the surface of the cervix.
We hope that by observing the use of various antioxidants on these tumors, we will gain insight into the possible effect on the already damaged DNA. Remember, cancer is a multistage process, and even precancerous tumors are in a relatively advanced stageThe next step in the multistage process is the development of a true cancer itself.
As you may imagine, great interest has piqued in the prevention and treatment of leukoplakia. Several studies have shown these tobacco chewers ha\~ low antioxidant levels. Consequently, those with the highest level of antioxidants also demonstrate the lowest risk of developing leukoplakia.
Dr. Harinder Garewal wrote a review article on the effect of antioxidants not only in the prevention of oral cancer but also the reversal of leukoplakia. This article is landmark to Phase III of chemoprevention. His findings provide hope that not only can antioxidants halt the process of developing cancer, they may actually empower the body's repair system to reverse cell damage.16 I've briefly recapped in the box several of the clinical trials he studied.
Here is a list of studies that involve the use of nutritional supplements in patients with precancerous lesions:
1. A study in India used vitamin A and beta-carotene: researchers observed complete remission of the leukoplakia at a rate ten times greater than the placebo group.
2. A pilot study that used only beta carotene showed a reversal of the leukoplakia back to normal cells in 71 percent of their patients.
3. In an ongoing study in the United States patients received a combination of beta carotene. vitamin C and vitamin E; researchers witnessed a response rate of 60 percent. The abnormal precancerous cells reverted back to being normal cells.
4. In an ongoing multi institutional U.S. trial patients received only beta-carotene: they had a response rate of 56 percent.
5. A study done with male hamsters that had experimentally induced oral cancer considered using beta-carotene. vitamin E glutathione. and vitamin C both in combination and alone. Significant improvement occurred in each group: however. the group receiving the combination had by far the best results. This was not merely an additional effect as more and more antioxidants were used but rather the results of a synergistic effect of the supplements working together.17
Cervical dysplasia is another precancerous tumor that occurs on the surface of the body Several studies have shown that individuals with low levels of beta-carotene and vitamin C have significantly increased risk of cervical dysplasia. In fact women with the lowest levels of beta-carotene had two to three times more risk than women with the highest levels. Women who had an intake of less than thirty milligrams of vitamin C per day had a ten times greater risk of cervical dysplasia than women whose intake was higher. Other epidemiological studies have shown that dietary deficiencies in vitamin A, vitamin E, beta-carotene, and vitamin C increase the risk of cervical cancer.'6
Beta-carotene supplementation actually has been shown to prevent cervical dysplasia from progressing to cervical cancer. In addition, some clinical trials have shown the role of vitamin C and beta-carotene in reversing or reducing the risk of cervical dysplasia altogether.'9
Though medical science attempts to find the one "magic bullet" nutrient in each of these specific cancers, as a clinician, I try to determine principles that will be beneficial for my patient. After researching studies like the ones mentioned here, I have no doubt these antioxidant nutrients work together, in synergy. As I said in Chapter 5, this means we not only need an assortment of different antioxidants, but we also need the minerals (manganese, zinc, selenium, and copper) and the B vitamins that support their enzymatic functions.
I am awed by the incredible ability God has built into the body to not only protect itself against oxidative stress but to repair damage wrought on the DNA of the cell. Several ongoing clinical trials will further determine the roles of antioxidants in reversing this process of carcinogenesis. In the meantime, remember, leukoplakia and cervical dysplasia are at the very end of cancer's multistage process, and yet studies show how the body can repair itself when we provide it with optimal levels of a few select antioxidants.
What If I Already Have Cancer?
Granted, chemoprevention therapies really exist for individuals who have not yet developed full-blown cancer. And standard therapy for cancers doesn't always appear promising. These therapies involve surgery (when feasible), chemotherapy, and radiation for solid tumors such as cancers found in the lung, the breast, the colon, and so on. In spite of medical research efforts, these therapies seem to have reached a plateau.
The bad news continues. Despite evidence of increased cure rates in the treatment of Hodgkin's lymphoma, childhood leukemia, and testicular cancer, there is growing fear of the development of secondary cancers and complications that are the result of these treatments.2'3
The good news lies in the fact that medical research is beginning to support the idea of supplementation with a mixture of antioxidants and supporting nutrients. This mix can actually enhance traditional chemo- and radiation therapy while at the same time protecting normal cells from toxic effects.
Kymberly was in her fourth year at Westmont College in Santa Barbara, California, working toward her degree in communication arts when she developed abdominal discomfort and bladder pressure. She went to the campus doctor, who diagnosed her as having a bladder infection and prescribed some antibiotics. But Kymberly's condition worsened. She experienced increasing abdominal pain, nausea, and vomiting.
While lying down, she was able to feel a mass in her lower abdomen. Obviously this frightened her terribly, and she went back to her doctor immediately. When he reexamined her, he could feel a mass the size of a grapefruit. He ran a blood test called a CA 125, which is a cancer marker for gynecological cancers and bowel cancers. Kymberly's marker was extremely high, and surgery was scheduled right away.
At age twenty-one, Kymberly had ovarian cancer. This being an unusual disease for such a young woman, the diagnosis caught her and her family totally off guard. After surgery the surgeon was quite optimistic that he had removed it all. He wanted to take every precaution, however, and requested that Kymberly see the oncologist. Her oncologist insisted that she go through some heavy chemotherapy, primarily because of her young age-she still had a lot of life ahead of her.
It was about this time that Kymberly consulted me. She wanted to know about nutritional supplementation as she was going through these treatments. She started an aggressive nutritional supplement program and scheduled her chemotherapy. Kymberly did not want to drop out of school, even though her doctors strongly recommended it. She was one student who was determined to give it her best shot, so she scheduled her chemotherapy treatments in Santa Barbara where she would continue to attend classes if it proved possible.
The young communications major did remarkably well through her treatments. She was able to carry a full load in college. Both Kymberly's oncologist and surgeon commented on not only how great she looked but also on how well she was tolerating her treatments. She did lose her hair, but she did not miss many classes. During her last treatment, the oncologist walked over to Kymberly and asked her directly, "What are you taking?"
Looking up, she replied, "What do you mean?"
He said, "I know you have to be taking something because all my other patients are over there vomiting, but you are here reading Time magazine."
When she told him about the nutritional supplements she'd been trying, he was impressed. Not only had she tolerated her treatments well, but she had responded so well to them.
Kymberly continues to thrive. It has been more than three years since she finished her chemotherapy Her hair has come back beautifully, and she is enjoying life. Her CA 125 blood counts have remained normal, and she is now having them checked only twice a year. Kymberly has had no sign of recurrence of her cancer.
Why Antioxidants Work
Oncologists and radiation therapists usually discourage the use of antioxidants in patients receiving treatments for their cancer. Why? Physicians are concerned with the possibility that antioxidant supplements will build up the antioxidant defense system of the cancer cells and result in making their treatments less effective, since their treatments primarily destroy cancer cells by creating oxidative stress. This is a reasonable concern. But the medical literature does not support their position.
Drs. Kedar Prasad and Arun Kumar and their colleagues at the University of Colorado Medical School Radiology Department reviewed more than seventy studies to address this concern. They titled their report, "High Doses of Multiple Antioxidant Vitamins: Essential Ingredients in Improving the Efficacy of Standard Cancer Therapy," which appeared in the Journal of the American College of Nutrition. There, Drs. Prasad and Kumar noted a few scattered studies that show a negative effect of using one nutrient in supplementation with certain chemotherapeutic treatments. When high doses of multiple antioxidants were used together, however, the therapies were enhanced.'' Now why would this happen?
Antioxidants Help Destroy Cancer Cells
Clinical research is revealing that cancer cells take up antioxidants differently than do normal cells. Normal, healthy cells will take up only the amount of antioxidants and supporting nutrients they need. This is a very important scientific fact when it comes to the principles of cellular nutrition.
Cancer cells, on the other hand, continue to absorb antioxidants and supporting nutrients without knowing when to quit. This intake of excessive antioxidants actually makes the cancer cells more vulnerable to cell death. Antioxidants not only aid in the battle against cancerous cells, they improve the defense of healthy cells against the damaging effects of radiation and chemotherapy.
Antioxidants Help Good Cells
It is common knowledge that almost all of the harmful side effects of chemo- and radiation therapy to normal cells are the result of the increased oxidative stress these treatments create inside the body. What is not common knowledge, however, is that when a patient takes high doses of antioxidant supplements, he improves the defense system of normal cells since they take up these antioxidants normally. This creates a true win-win situation. Chemo and radiation therapy can work at a peak while at the same time the terrible side effects and damage that occurs to the healthy cells is significantly reduced.
Vitamin E protects against the damage caused by various chemotherapeutic agents to the lungs, liver, kidneys, heart, and skin. CoQ10 has been shown to protect against the long-term damage to the heart that the drug Adriamycin causes. Beta-carotene and vitamin A reduce the adverse effects of radiation and some chemotherapeutic agents. All of these antioxidants have been shown to help protect against the DNA damage to normal cells that cancer treatments cause.
Michelle was a beautiful, vibrant four-year-old. Her world was filled with love and lots of laughter. It appeared that nothing could penetrate the safe haven of her family. But Michelle's carefree life changed. Doctors discovered the discomfort she was experiencing in her back and abdomen came from an aggressive cancer called a neuroblastoma. The family was devastated.
Michelle underwent exploratory surgery shortly after the diagnosis. When the surgeon emerged from the operating room, the family could see from his face that the news was not good. He informed them that Michelle's tumor had spread, stretching clear up to her diaphragm, and had wrapped around the bowel and the large vein in her abdomen. There was no way he could remove it.
Before Michelle even recovered from her exploratory surgery, her oncology team started her on aggressive chemotherapy but still was not optimistic about Michelle's chances for long-term survival. This was when Michelle's mother consulted me. She wanted to do everything possible to protect her daughter from the potential side effects of the treatments the doctors recommended.
We started Michelle on an aggressive nutritional supplement program in spite of her doctor's objections. Michelle was a trooper and took her supplements faithfully. Her treatments began, and she struggled through them. She did become fairly sick even though she was taking the supplements. Because the treatments were exceptionally strong, there was serious concern that she could actually survive them. But brave little Michelle made it through, and the tumor shrunk significantly.
Michelle's response so encouraged her doctors that they wanted to take her back into surgery to see if they could remove the tumor. This time the surgeon emerged from the OR with a smile on his face. He said they felt they were able to get all of the tumor. The oncologist informed Michelle's parents that her response to the chemo could not have been better.
But Michelle's journey was not over. The doctors still wanted her to go through a bone marrow transplant to ensure that any microscopic spread of the cancer was removed. The family faced another tough decision. They carefully considered all the information they could gather, and then based on that information, Michelle's father told the oncologist that they would consent to the bone marrow transplant. The physician could proceed on one condition only: Michelle's parents insisted that she be on nutritional supplements during the bone marrow transplant.
At first the oncologist refused. She believed the nutritional supplements would block the effectiveness of her treatments. When Michelle's father asked the oncologist if she had any studies in the medical literature that supported her concerns, the oncologist replied, "No, but it is a theoretical concern."
Then Michelle's father, who was also an ER physician, revealed that she had been taking supplements all during her previous treatment. She had not only survived the treatments but experienced an exceptional response. Michele's father made it clear that he and his wife insisted that she stay on the supplements while going through the bone marrow transplant.
The oncologist agreed to have the oncology pharmacologist investigate the supplements Michelle was taking to be sure there would be no conflict with the drugs. After extensive research by the pharmacologist, all agreed that Michelle could receive supplements during the bone marrow transplant after all. The procedure was rough, but she survived, and she did recover. In fact the oncologist told the parents that she had never seen any child recover more quickly from such a procedure. Their tough stand had been well worth the effort.
Michelle and her mother prayed many times through those difficult months that when she turned five, she would be able to start kindergarten with her friends. And Michelle was strong enough to make that first day of kindergarten. It has been more than three years since she was first diagnosed with the cancer. At age seven Michelle is busy riding bikes, jumping rope, and keeping up with fashion and her girlfriends.
Nutritional science offers us the greatest hope in our fight against cancer and several other degenerative diseases. They not only help prevent cancer but may actually enhance the traditional chemo- and radiation therapy. How can the process of building up the body's natural defense be bad? Shouldn't physicians want their patients to be as healthy as possible, since cancer treatments are going to put patients under the greatest stress they have had to endure in their lives?
Natural antioxidants and their supporting nutrients are the ideal chemo-preventive agents for many reasons
o They limit and even prevent the free-radical damage to the DNA nucleus of the cell.
o provide the proper nutrients needed for the body to repair any damage that has been done already.
o are safe and may be taken over a lifetime. (Pharmaceutical drugs do not share this advantage. Tamoxifen, which has been shown to decrease the risk of breast cancer, has very serious side effects.)
o are relatively inexpensive. (The nutrients I recommend for prevention cost between $1.00 and $1.50 (US) per day.) Pharmaceutical Grade Supplements
o provide the best defense against further advancement of cancer.
o protect the body against oxidative stress that chemotherapy and radiation create.
o embellish the cancer-fighting ability of chemotherapy and radiation.
o inhibit the replication and growth of the cancer.
o have been shown to cause tumor regression in some instances.22
We cannot deny that the effectiveness of traditional cancer treatments has reached a plateau. Oncologists and radiation therapists must become more open-minded about antioxidant use in their patients. AS researchers seriously consider the use of multiple antioxidants at optimal levels, cancer prevention and treatment may well be revolutionized. In the meantime the research that is presently available supports the use of antioxidants in all stages of chemoprevention and cancer therapy.
"What Your Doctor Doesn't Know About Nutritional Medicine May Be Killing You."
Dr. Ray Strand http://www.raystrand.com/bookstore.asp
American Cancer Society: http://www.cancer.org/