Diseases cannot be reduced to pathological facts, they constitute other worlds. -Oliver Sacks Historically, the Ramayana records the earliest evidence of treatment for a malignant tumour by the knife and by arsenical compounds. In today’s terms, this would be described as surgery and chemotherapy, respectively.Hippocrates (375-460 BCE) coined the word karkinoma derived from the Greek word karkinos, meaning crab. Subsequently, this name stuck because of medicine’s inability to get rid of malignant tumours and their capacity to infiltrate and attach themselves to adjacent tissue. In eras gone by, reports of cancer were anecdotal at best-not like the escalated rampant disease that we witness today, where almost every family knows of someone afflicted by cancer.What went wrong? We live longer, for one. The sea of carcinogens or cancer- causing substances surrounding us-be it in the food we eat,the water we drink, or in the environment-has that much more time to work on our bodies. Most of these carcinogens, which have also increased exponentially over time, are our own, human creations. In our daily swim, we manage to navigate through most of them without serious impact. This is due to inherent factors, namely a healthy body and a sound mind. In fact, despite these trying circumstances, we have an infinite ability to heal ourselves.The development of cancer in our body is a multi-step process and is slow to unfold. How long a cancer really takes to develop is difficult to predict. It could be months or years. To begin with, these changes can be easily corrected by our own defence mechanisms, primarily through the

CANCER, YOUR BODY AND YOUR DIET

Immune system and the ‘molecular policeman’ of the cell gene.The immunological and biological surveillance that exists in our body manages to remove mutated or abnormal cells-as in the case of infectious organisms- and we continue to live in a state of good health It is believed that the DNA mutations (alteration in the chemical structure of DNA) that lead to the development of cancer occur on several occasions during our lifetime Mostly, the body comes out healthy, having eliminated the mutation. At other times, the mutations progress further in a multi-step process, and eventually evolve into cancer over a period of time. The factors responsible for the switching ‘on’ of the cancer trigger are not exactly known, but poor general health, improper nutrition, environmental factors and stress are a few suspects in the long list of probabilities.Although tumours may appear at any age, they are most likely to occur in older individuals, suggesting that environmental factors may be at work. Another peak for malignant tumours is during childhood, but this is quite distinct from the adult form of the disease, as it arises in organs or tissues with rapid growth, like bone marrow, bones and neural tissues. Rapidly growing tissue may be subject to mutations resulting in the development of cancer.In their abnormal mutated state, the cancer cells manage to mask themselves and escape the fury of the immune system–they are immortalized and continue to grow unhindered, not responding to the signals from adjacent cells to stop multiplication. Moreover, they manage to requisition the surrounding normal tissues and their functions for their own growth and proliferation at the expense of the host, just like a parasite. that may be etabolically three times more active than Malignant tumours comprise rapidly multiplying cells normal tissues. Thus, the tumours sift out a greater portion of the nutrients present in blood circulation, that have been

WHAT IS CANCER?

Absorbed from food, for their own nutritional needs. This greatly reduces the availability of essential nutrients for the normal metabolic functions of the host cells—effectively starving them. Some cancer patients succumb directly to their tumours; more succumb indirectly, because of severe malnutrition. In this weakened condition the patient often develops an immune-deficient state and becomes highly susceptible to infections like neumonia. Doctors and care-givers have consistently confronted a major challenge in cancer patients: reduced appetite, exacerbated by the treatments given-chemotherapy and/or radiation therapy. It is crucial therefore to provide a higher caloric diet to meet the additional nutrient needs of the patient, and to ensure that even if the patient can’t eat very much, what they do eat is significantly nutritious. Cancer is a complex disease characterized by multiple genetic and molecular alterations of the cells. These alterations involve fundamental changes in the ability of the body to: kill and dispose of old and abnormal cells; regulate unfettered ultiplication of abnormal cells; control the abnormal cells’ ability to break their moorings and locally infiltrate and destroy adjacent normal tissue; and/or their spread into distant organs. Therefore, surgical removal of tumours should include adequate excision of surrounding tissue, failing which local recurrence of the tumour is inevitable. Further, the tumour cells influence the growth of new blood vessels that carry nutrition to the developing cancer cells. For all these changes, the growing cancer depends entirely on the host for its nourishment. It then seems logical for us to look at our diet and introduce changes in our food habits that could interfere with tumour growth and keep cancer growth on hold. We are aware of many substances whose abuse may cause cancer. Some of these, like tobacco, whether chewing or smoking, excessive consumption of alcohol, and aflatoxin in

CANCER, YOUR BODY AND YOUR DIET

Substances however, which are invisible and therefore may be peanuts, can clearly be avoided. There are many carcinogenic considered unavoidable. We are unaware of their presence in our food, our water, or in the environment, and even of their harmful effects. We need to work around these toxins: firstly by educating ourselves on the content of our diets , be it our food or what we drink; secondly, by introducing foods that may have a protective effect against cancer. Making a few changes in our food habits could go a long way in improving the state of our health. One study suggested that only 5 to 10 per cent of cancers were attributable to genetic or intrinsic factors; 90 to 95 per cent of cancers have their roots in environmental toxins, infections and our lifestyle (i.e. extrinsic or epigenetic factors). Cancer risk, therefore, is heavily influenced by extrinsic factors and only marginally by intrinsic ones. Further, a study conducted in the US revealed that 30 to 35 per cent of cancers were linked to diet, 25 to 30 per cent of cancer-related deaths were due to tobacco, while 15 to 20 per cent were due to infection. Other minor causes were radiation, stress, lack of physical activity and pollution. The authors of this study suggest that cancer was a preventable disease that requires major lifestyle changes. In the US, there has been a 25 per cent decline in cancer deaths over the last two decades. More than half can be attributed to cancer prevention strategies. The single most preventable cause of cancer is cigarette smoking. Decrease in tobacco use is largely responsible for this reduction applying this logic to other known causes of cancers and avoiding them would result in the reduction of these preventable cancers.Epigenetic factors are external or environmental factors that cause changes in the functioning and/or regulation of DNA without altering their primary sequence. These are factors that switch the genes ‘on’ and ‘off’, and affect how

WHAT IS CANCER?

Cells read the genes, or how the genes express themselves.Essentially, it is anything other than the DNA sequence or code that influences the development of the cell. Some common epigenetic factors that influence the development of cancer include deficiency of folic acid, smoking, heavy metals and pesticides, to name but a few. It is therefore believed that you can shift your gene expression through nutrition and lifestyle choices.Is psychological stress the cause or an effect of cancer? Though stress has no direct link in the causation of cancer, repeatedly dealing with stressful situations over long periods of time can cause health problems. The body responds to stress by releasing stress hormones (epinephrines) that not only increase the blood pressure and heart rate but raise the blood sugar levels, which may be responsible for a weakened immune system.Stress may result in behavioural changes; for instance,increased smoking in smokers, overeating and obesity, or an increased intake of alcohol. All these changes increase cancer risk and, in fact, are extremely unhealthy choices.On the other hand, a diagnosis of cancer definitely causes stress, from the time of diagnosis all through treatment and even after its completion. The stress of whether there will be tumour recurrence never truly goes away.