1: The wife of a close friend of Dr. Peter Attia was diagnosed with breast cancer.
“Sandra (not her real name) had been diagnosed with breast cancer six years earlier,” Peter writes in his book Outlive. “It had already spread to her lymph nodes and her bones. Because of her poor prognosis, she qualified for a clinical trial of an experimental PI3K-inhibitor drug, in combination with standard therapies.”
What do we know about Sandra?
First, according to Peter, she was “a very motivated patient. From the day of her diagnosis, she had become obsessed with doing anything possible to stack the odds in her favor. She devoured everything she could read on the impact of nutrition on cancer, and she had concluded that a diet that reduced insulin and IGF-1 would aid in her treatment.”
Sandra put together a diet that “consisted primarily of leafy vegetables, olive oil, avocados, nuts, and modest amounts of protein, mostly from fish, eggs, and poultry,” he writes.
“The diet was just as notable for what it did not contain: added sugar and refined carbohydrates. All along, she underwent frequent blood tests to make sure her insulin and IGF-1 levels stayed low, which they did.”
What happened next was surprising.
“Over the next few years, every other woman who was enrolled at her trial site had died,” Peter notes. “Every single one. The patients had been on state-of-the-art chemotherapy plus the PI3K inhibitor, yet their metastatic breast cancer had still overtaken them.”
It was clear that the drugs weren’t working. In fact, the trial was stopped.
“Except for Sandra. Why was she still alive, while hundreds of other women with the same disease, at the same stage, were not?” Peter asks. “Was she merely lucky? Or could her very strict diet, which likely inhibited her insulin and IGF-1, have played a role in her fate?”
2: The relationship between cancer treatment and diet is controversial and the subject of many clinical trials.
“Work by Valter Longo of the University of Southern California and others has found that fasting, or a fasting-like diet, increases the ability of normal cells to resist chemotherapy, while rendering cancer cells more vulnerable to the treatment,” Peter writes.
“It may seem counterintuitive to recommend fasting to cancer patients, but researchers have found that it caused no major adverse events in chemotherapy patients, and in some cases, it may have improved the patient’s quality of life.
“A randomized trial in 131 cancer patients undergoing chemotherapy found that those who were placed on a “fasting-mimicking diet” (basically, a very low-calorie diet designed to provide essential nutrients while reducing feelings of hunger) were more likely to respond to chemotherapy and to feel better physically and emotionally.”
This approach to diet is contrary to the traditional path, “which is to try to get patients on chemotherapy to eat as much as they can tolerate, typically in the form of high-calorie and even high-sugar diets,” Peter writes.
“The American Cancer Society suggests using ice cream ‘as a topping on cake.’ But the results of these studies suggest that maybe it’s not such a good idea to increase the level of insulin in someone who has cancer.”
3: A new cancer threat emerged in the 1990s and early 2000s just as the occurrence of smoking-related cancers was going down.
“Obesity and type 2 diabetes were snowballing into national and then global epidemics,” Peter observes, “and they seemed to be driving increased risk for many types of cancers, including esophageal, liver, and pancreatic cancer.
“The American Cancer Society reports that excess weight is a leading risk factor for both cancer cases and deaths, second only to smoking.”
The percentage of cancer cases attributable to obesity is about 12 to 13 percent globally.
“Obesity itself is strongly associated with thirteen different types of cancers,” Peter notes, “including pancreatic, esophageal, renal, ovarian, and breast cancers, as well as multiple myeloma.”
Type 2 diabetes also increases the prevalence of some cancers “by as much as double in some cases (such as pancreatic and endometrial cancers),” he observes. “And extreme obesity (BMI ≥ 40) is associated with a 52 percent greater risk of death from all cancers in men, and 62 percent in women.”
Which means changing our diets to lower insulin levels could potentially help “slow the growth of some cancers and reduce cancer risk,” he writes.
“While it’s tricky to impossible to avoid or prevent the genetic mutations that help give rise to cancer,” Peter notes, “it is relatively easy to address the metabolic factors that feed it.
“I’m not suggesting that it’s possible to ‘starve’ cancer or that any particular diet will magically make cancer go away. . . What I am saying is that we don’t want to be anywhere on that spectrum of insulin resistance to type 2 diabetes, where our cancer risk is clearly elevated.
“To me, this is the low-hanging fruit of cancer prevention, right up there with quitting smoking. Getting our metabolic health in order is essential to our anticancer strategy.”
More tomorrow!
___________________________
Reflection: Have I, a family member, or a close friend battled cancer? If so, what were the lessons I learned? How has this experience impacted me? Does anything surprise me about the metrics regarding cancer?
Action: Journal about my learnings.
What did you think of this post?
