© April 1999
Whole Foods Magazine
Dr. Gaynor’s Cancer Prevention Program and More:
An interview with Dr. Mitchell Gaynor
Richard A. Passwater, Ph.D.
For the past two years, I have received more questions about how to prevent breast cancer than about any other subject. Now, at last, I can refer these questions to an excellent prevention program that is detailed in a very readable book by Mitchell L. Gaynor, M.D., and Jerry Hickey, R.Ph. Dr, Gaynor will chat with us this month and share some of the important features of his excellent cancer prevention program.
Previously, the most frequent questions I encountered were about aging, heart disease and lung cancer. I assume that the interest in breast cancer prevention is acceptance of the fact that diet and the environment have a lot to do with the incidence of breast cancer. One thing is certain: the sudden burst of interest in diet and breast cancer does not stem from a concomitant surge in the occurrences of the disease itself.
In fact, the incidence of breast cancer increased 1.8% per year from 1973 until 1990, but then remained level from 1990 through 1995. Meanwhile, the death rate from breast cancer for white and Hispanic women actually dropped by 1.9% per year from 1990 to 1995. In 1998, however, when all the numbers are tallied, we will find that an estimated 178,700 American women have been diagnosed with breast cancer, and an estimated 43,500 American women will have died as a result of the illness. These numbers continue to be too high for any sense of comfort.
What then can we do to decrease the risk of breast cancer? In addition to recognizing the previously accepted risk factors, which center around genetics and exposure to estrogen, we also should alert the public to several dietary and environmental factors that can be considered risk factors useful for predicting the occurrence of the disease in groups of similar people. The following should be included: estrogenic diets, deficiency of antioxidants, consumption of too many total calories, exposure to environmental xenoestrogens, deficiency of B-complex vitamins, high carbohydrate diets (because of their effect on insulin), over consumption of red meat, tobacco smoke and over exposure to the sun.
Notice that I did not include the darling of establishment nutritionists--high-fat diets. It is the type of dietary fat and what is stored in dietary fat that is important. Of course, body fat increases breast cancer risk because it is estrogenic. Body fat can come from too many calories of any type-- carbohydrate, protein or fat. High-fat diets may increase the risk for other cancers or other diseases, but let’s not blame them for more than the evidence shows.
I used the term “xenoestrogen.” This is not to be confused with “phytoestrogen.” Phytoestrogens inhibit estrogen uptake. Xenoestrogens are chemicals from the environment that act in the body the same way that estrogen does. They bind to estrogen receptors and stimulate transcription and cell production. Examples of xenoestrogens are organochlorines (DDT, PCB, atrazine. etc.). Also, chemicals leeched from plastics, including polycarbonate water bottles and baby bottles (nonylphenol, bisphenol-A (BPA), etc.) Cell culture studies show that these chemicals increase breast cancer cell growth.
Now let’s turn to Dr. Gaynor to see how his program protects against these risk factors. Dr. Gaynor has incorporated his clinical experience with the latest scientific research to develop a personalized program that is a “whole person” approach.
Dr. Gaynor is the Director of Medical Oncology at the Strang Cancer Prevention Center, a New York Hospital/Cornell affiliate. He is a board-certified oncologist, hematologist and internist. He is also a member of the Executive Review Panel at the Department of Defense Alternative Medicine for Breast Cancer. He is listed in the 1997 edition of How to Find the Best Doctors, New York Metro Area.
Passwater: Dr. Gaynor, it is thrilling to see an oncologist from a leading cancer treatment center become an activist for preventing cancer. What drives you so hard at putting yourself out of business?
Gaynor: My mother died of breast cancer when I was nine years old, and I don’t want anyone to have that experience repeated.
Passwater: What turned your interest toward nutrition?
Gaynor: I was trained at one of the best medical schools in the country. I went to the University of Texas Southwestern Medical School and then came to New York in 1982 to do my internship and residency in internal medicine at Cornell University Medical Center. Subsequent to that I did a Fellowship in hematology-oncology at Cornell. It is fair to say that during that entire time I learned very little about nutrition. Then as a part of my Fellowship, I went to Rockefeller University where I studied nutrient-gene interactions.
I studied how various nutrients could effect the immune system and also
learned about various genes that could either lead to or prevent cancer.
I was absolutely flabbergasted that there were not hundreds, but literally
thousands of scientific papers showing how a variety of nutrients
Including vitamins could so positively affect genes and potentially influence the immune system to prevent cancer. I vowed at that time that
I would make it my life's work to bring this information to clinical medicine.
Passwater: Why did you select the Strang Cancer Prevention Center for your practice?
Gaynor: The interest in prevention goes to the heart of the Strang Cancer Prevention Center's mission. As many of our readers may be aware, the Pap smear was developed at Strang about 60 years ago. At that time, Dr. Papanicilou developed a test in which a few cells from the lining of the cervix could be used as a screening test for cancer. This test has gone on to prevent more deaths from cancer than any single test ever developed.
Passwater: The Pap smear is not just for early detection of existing cancer. In addition, it can detect abnormal cells before cancer development. Yet when the test was initially developed, it was largely criticized by virtually the entire medical establishment as being "preposterous" for proposing the concept that a disease like cancer could be prevented.
Gaynor: The test largely ignored for about a dozen years after being published in a leading medical journal. This was a new paradigm, and it takes time for new paradigms to be accepted. At Strang, we have had a 25-year commitment to looking at Nutritional modalities, screening modalities, and exercise as the three pillars of cancer prevention. As a cancer specialist who treats people with cancer every day, I can assure you by far the best solution to cancer is to never get it in the first place. At this point in time, that has become a definite possibility. Studies such as the one recently published in the British Medical Journal on December 12, 1998 have suggested that up to 80% of colorectal and breast cancer could be preventable through diet.
Passwater: What is the story behind the Ann Fisher Nutrition Center within the Strang Cancer Prevention Center?
Gaynor: The Ann Fisher Nutrition Center was created three years ago after Ann Fisher, who is a major proponent of nutrition and cancer prevention, gave a large grant to the Center. Ann Fisher is the wife of Jerome Fisher, who is the founder and leading shareholder of the 9-West shoe store chain.
This Center is the only nutritional oncology center of its kind in the world.
People can come here and obtain a complete analysis of their food records, their risk of developing cancer, their family history, genetic screening and more. This is literally "a bench- to- bedside approach," meaning that the very best and latest research in phytonutrients and vitamins, will be brought to the clinic and applied. Based upon a patient's risk, his or her food allergies, vitamin levels (which we measure via blood samples) and a computer analysis of food records and dietary history, we develop formal recommendations about what types of foods and supplements each individual should be taking.
Passwater: You become involved not only with protective foods, but with dietary supplements. It is my understanding that many oncologists are not receptive to using dietary supplements. In giving their reasons, some say they are concerned about unproven efforts to cure cancer with the food supplements.
What role do you see dietary supplements playing in the prevention of cancer and as an adjunct or support of therapy in the treatment of cancer?
Gaynor: The right foods are as important to preventing cancer as wearing a seatbelt is to avoid being killed in an auto accident. We take preventive actions every day of our life. We brush our teeth to prevent tooth decay, we lock the doors to our homes to prevent burglary. Of course, these preventive measures don’t give us a 100% guarantee that nothing bad will happen.
No such guarantee exists in life. But it still is critically important that we do these things because they can reduce the risks significantly.
The dietary supplements we recommend are important for one reason: Most people do not adhere to an optimal diet such as the one I propose in my book and that we propose at the Strang Center. Such a diet would include six to eight servings of various fruits and vegetables every day. There would be at least two cups of green tea every day. Cooking would be done with olive oil and nutritional herbs, including rosemary, garlic and curcumin. Flax seed and soy would be used every day. If people would do all of these things, there might not be any need for supplements.
But the fact is that only a small percentage of people eat this healthfully.
I hear people say, day-after-day, “you know, I have a family to take care of. I have to take my kids to Cub Scout meetings after school, I have to travel for my job. Frequently, I have to eat in restaurants.” This is the stuff of modern life that makes it impractical for people to rely on diet alone. Even if people are aware of what they need, they are too busy to follow through. Thus, they rarely get the really necessary phytonutrients through food alone.
Passwater: Micronutrients too, are in very low supply in such hit or miss eating patterns.
Gaynor: I’m sure that most of our readers are familiar with Dr. Larry Clark’s study
published in the Journal of the American Medical Association in 1996. He looked at the mineral selenium and showed that the group that was taking 200 micrograms a day of selenium as high-selenium yeast supplements lowered their risk of prostate cancer by 63%, their risk of colorectal cancer by 58% and lowered their risk of lung cancer by 46%. Total cancer incidence rates were lowered by 37%, the total cancer incidence dropped 45%, and the total cancer death rate was cut in half. That was one powerful study.
Another study, called “The Health Professional Study,” published in the Journal of The National Cancer Institute in 1995. This one which looked at men who consumed 10 or more tomato based products a week, found that the subjects likelihood of developing prostate cancer was lowered by 46%
Now, you and I know that not many people are going to eat 10 or more tomato-based products a week. But, since we have learned that the active phytonutrient in tomatoes is lycopene, doesn’t it makes sense on the days when we are not consuming tomato based products to take a lycopene supplement? Doesn’t it also make sense on days when we are not able to consume enough selenium-rich foods, to take a selenium supplement?
Not long ago, the Journal of the National Cancer Institute published a report about a report about a study in Finland in which 29,000 males took just 75 units of vitamin E in supplemental form a day. Among these men, the researchers found a one-third reduction in the risk of developing prostate cancer. These are the types of studies that I find immensely persuasive. And they go on and on and on, showing that not just foods, but
supplements as well, can be mightily beneficial. Nobody should think of
supplements as a replacement for a good balanced diet, but it definitely can be a useful adjunct.
Passwater: The medical community use to ridicule the concept that nutrition was a factor in reducing cancer risk. I reported on my research showing that antioxidant nutrients were synergistic in reducing cancer incidents in laboratory animals in 1973. Then this was a new concept for even the scientific community, so I didn’t expect the medical community to be convinced at that time. In fact, even the US Patent Office was skeptical at that time, but it was issued as U. S. Patent # 6,090,414.
In 1975, my book Supernutrition: Megavitamin Revolution was published. In it, I put forward the results of my research showing that synergistic combinations of antioxidant nutrients reduced the risk of cancer. At the time, I was ridiculed by the American Cancer Society.
Two years later, in 1977, I interviewed Dr. Michael Sporn at The
National Cancer Institute and found that a slight shift was taking place. For the first time, there was an acknowledgement that it might be more efficient to prevent cancer than it was to treat cancer that already had developed
Still diet was not the focus. Dr. Sporn was using 13-cis-retinoic acid, a vitamin A derivative that was considered a drug.
In 1978, I elaborated on diet and supplements in cancer prevention in my
book “Cancer and Its Nutritional Therapies, but there still was no general acceptance of the concept. For that matter, as recently as 1987, a suit was filed against Whole Foods and myself personally, essentially for promoting the concept that diet was related to cancer incidence. Of course, this suit was dismissed by the court before ever going to trial, but this was a reflection of the attitude still prevalent at that time.
It wasn’t until the 1991 New York Academy of Sciences meeting in Arlington, VA did establishment nutritionists begin to realize that nutrients had protective actions against the major diseases and were not limited to only deficiency and growth.
Now, it is appearing that many scientists and physicians have come to grips with the realization that nutrients are involved in health beyond deficiency disease.
Earlier we discussed why you became interested in utilizing nutrition to help prevent cancer, but when was the “eureka moment” when you became convinced that nutrition was a major factor in cancer risk?
Gaynor: I largely made this realization at Rockefeller University when I saw how the overwhelming preponderance of epidemiologic and basic research study showed how nutrition was critical to a lower risk of cancer and how diet could be used as a preventative mechanism. And, you know, I was somebody with the best medical training in the world and prior to the time I was at Rockefeller, I was not taught anything about these studies. So, I think it is really a matter of getting this information out there.
I really hope that my book is going to be an important tool in getting this information out, not just to patients and the people who are interested in lowering their risk of cancer, but to health care practitioners such as doctors and nutritionists who are out there on the front lines taking care of people and being able to answer the questions that these people raise. That is why I so carefully referenced all the studies in the book, so that people can really "hang their hat" on the recommendations that Jerry and I have made.
By the way, I feel very fortunate to have written the book with Jerry Hickey, who is one of the top nutritional pharmacists in the country, because he was able to give the book a very practical, almost a “how to” approach. He is very familiar with the best supplements and the best supplement manufacturers. Also, in the very convenient pharmacist corners in the book, he was able to tell people about any nutrient-drug interactions that may be important.
Passwater Do cancer organizations concur with your conclusions?
Gaynor It is really very rewarding to see that the leading cancer organizations including The American Cancer Society, have come down so positively on the role of nutrition in preventing cancer over the last year. I have actually been asked to speak to a group of cancer survivors at the American Cancer Society this April in New York City. I have been asked to speak at many national cancer survivor organizations on the role of nutrition, not just people that are interested in preventing cancer, but in people that have already had cancer and I have a whole section in my book on nutrients for patients with cancer where I reviewed the vast amount of literature that is coming out on the role of adjunctive nutrition in patients already with cancer.
One of the studies I cite in our book was conducted at the West Virginia University School of Medicine. The researchers looked at people with early stage bladder cancer who were getting a type of immune therapy injected directly into the bladder. Half of the group just got RDA doses of vitamins; the other half got very high doses of a variety of antioxidant and vitamins. The rate of recurrence of bladder cancer was lowered by half in the group taking the high doses of antioxidant and vitamins. There are numerous studies coming out now that stress the synergy between these types of phytonutrients including soy, including antioxidants and including B vitamins with chemotherapy and immune therapy.
Passwater: What was the message in your earlier book, "Healing Essence"?
Gaynor: “Healing Essence” was a book that really looked into the role of guided imagery and meditation in people with cancer and how important it was to really define the role that stress can have on our immune systems. There have now been hundreds of studies showing how negative emotions like stress, depression and pessimism can lower every aspect of our immune system. There was actually a study published about a year ago in “The Journal of the National Cancer Institute” that looked at women who were recovering from surgery for breast cancer and found the women with the greatest levels of stress had the most profound depression
in their immune system and the immune parameters that were
directly associated with protecting against the recurrence of cancer.
Passwater: Now you have bravely taken your message of nutrition in cancer prevention directly to the people. I say "bravely" because you as an oncologist are open to ridicule by your peers. Have your nay-saying peers criticized you for embracing cancer prevention?
Gaynor: Actually, I have received a tremendous amount of interest from physicians around the country. I have given grand rounds at some of the leading medical centers and medical schools in the country also on the role of nutrition in cancer prevention and I find something that is quite pleasantly surprising and that is there is usually a line of physicians after my talk, waiting to ask me what supplements I would recommend for them based upon their own personal histories.
This subject is of incredible interest to many people including physicians. Most doctors already take supplements, and there is a reason for this. I think that books like mine and Jerry's, so strongly rooted in science, will lead more and more people to weigh in on the side of nutrition.
Passwater: What about those who claim there is not enough evidence?
Gaynor: The answer to that question is, “Look at the references in book’s bibliography.” I cite hundreds and hundreds of scientific studies that show how a variety of nutrients can affect on a basic level and on epidemiologic studies, the genes and the hormone levels and the detoxifying enzyme levels in the body and, about how all these are clinically important in preventing cancer. There really is such a preponderance of data, its next to impossible to argue with.
Passwater: Cancer takes many years to develop. The process can be simplified into six basic sequences:
If someone already is undergoing the transformation of normal cells into cancer cells, is it too late for that person to take nutritional action? What are some specific points of attack in terms of treatment or prevention?
Gaynor: It is very important for people to realize that the disease we call cancer is the result of a decades-long process and that nutrition is a way of thwarting each step of that process. There is free-radical damage for instance of DNA which can lead to changes in the cell that eventually cause cancer. There is a variety of anti-oxidants from phytonutrients that can protect against this type of damage.
Also, every organ in the body contains detoxification enzymes. In fact, there is a study out of Johns Hopkins in 1998 which compared
women with and without breast cancer and they found the women
that had lower levels of a very important detoxifying enzyme called GST, were at a four-fold increase risk of developing breast cancer. There are a variety of nutrients that can actually increase the detoxifying enzyme levels in every organ from the lung to the
stomach, to the liver.
Examples of these types of foods are Omega-3 fatty acids,
antioxidant vitamin, soy, and cruciferous vegetables like broccoli,
Brussel sprouts, cauliflower and cabbage.
It is important to keep in mind that the lack of differentiation
characteristic of cells moving down the assembly line toward cancer can be reversed. Many types of cancer cells can be induced to differentiate to a less malignant form by exposure to various
nutrients. Cells that have begun to turn cancerous can be returned
Passwater: And, some nutrients can also stimulate our immune system to destroy cancer cells.
Recently, a study was released suggesting there is no link between
dietary fiber and colorectal cancer. What can you tell us?
Gaynor: I think that study was flawed for many reasons. It flies in the face of literally about 100 other scientific studies which suggest protective effect for a variety of dietary fiber in protecting against colorectal cancer as well as breast and prostate cancer.
In addition, this particular study showed a 35% increased risk of developing cancer in those that consume the most fiber and this point was conveniently left out of many of the stories that talked about this study. I mean, clearly, fiber is not going to cause a one-third increased risk in your rate of developing colorectal cancer, yet that is what this study showed. I think the study was seriously flawed based on the fact that it contradicts the majority of studies that have previously been done and flies in the face of common sense that eating fiber is going to cause a 35% increase in your chance of developing colorectal cancer.
Passwater: What can you tell us about antioxidants in cancer?
Gaynor: Basically, the research that you have done and many scientists like you have done, have shown that a variety of antioxidants lower our risk of developing cancer. Dr. James Enstrom and his colleagues at UCLA published a study in 1992 showing that there are people taking Vitamin C supplements had about a 15-20% lower risk of developing cancer. The studies on Vitamin E have shown lower rates of prostate cancer; the studies on carotenoids in general, show people with high carotenoid intake have a lower risk in general of a variety of cancers, especially breast cancer and GI cancers. I already mentioned the reduction of cancer by selenium.
Passwater: How about Omega-3 and Omega 6 fatty acids?
Gaynor: Omega-3 fatty acids are found in flax seed and cold-water fish. Flax seed is a good thing to supplement with. You can put a tablespoon or two of flax seed oil added to salads or cereals daily. There are also Omega-3 fatty acids found in deep cold water fish like salmon, cod, haddock and tuna. I think it is important to keep in mind that it is really the deep cold water fish that are going to be the richest in Omega-3 fatty acids. Actually a lot of the salmon that is being produced now is being raised in warm water and, the amount of Omega-3 fatty acids in those fish is not nearly as high as the cold water fish.
Omega-3 fatty acids can induce detoxifying enzymes which are the best line of defense against everything from cigarettes, secondhand cigarette smoke to diesel fumes to PCB's that contaminate much of our water supply in this country. They can also decrease inflammation which when chronic has been associated with an increased risk of developing cancer.
Passwater: How about soy?
Gaynor: There was a study published in the December 2, 1998 “Journal of the National Cancer Institute” where they looked at women who drank two glasses of soy milk a day. Now, this was not a lot of soy really and, it only contained 109 milligrams of soy isoflavones per day. But this amount of soy consumption decreased the estrogen levels in these women by about 25% and it decreased the strongest types of estrogen that we know are associated with many types of breast cancer. Soy also does a variety of other things. It can inhibit an enzyme called tyrosine kinase. This enzyme has been associated with a variety of types of cancer. Soy can also inhibit angiogenesis which is the formation of new blood vessels around tumors. Soy can also act as a weak estrogen that blocks
estrogen receptors and prevents the buildup of the stronger types of estrogen.
Soy also does a variety of other things. It can inhibit an enzyme called tyrosine kinase. This enzyme has been associated with several types of caner. Soy also can inhibit angiogenesis, which is the formation of new blood vessels around tumors. So, soy really is one of the best cancer protective
foods that you can eat and, I think this is one of the reasons the
Japanese women have 1/7 the incidence of breast cancer that
American women do and one of the reasons that Asian men
in general, have 1/30 the incidence of fatal prostate cancer that
American men do.
Passwater: Do you recommend any other supplements?
Gaynor: I think the variety of supplements that we talk about in the book really has to be tailored based upon what your risk factors are and based upon how good your diet is. If you are not able to eat six to eight servings of a variety of fruits and vegetables every day, I think it is very important that you consider a lot of the supplements that Jerry and I talk about in the book. We discuss green tea, lycopene, NAC, antioxidant vitamins, alpha-lipoic acid, squalene and much more.
Passwater: Your book is a complete cancer prevention program. It must be read from cover-to-cover which is easy to do because of its interest in readability. We can't chat about everything here but can you give our readers a "take home" message of the plan?
Gaynor: The bottom line -- the unfortunate fact -- is one in three people in this country are going to eventually hear the words, "you have cancer". However, the good news is, is there is a tremendous amount we can do to lower our risk of every having to hear these words.
The pillars of my suggested program are nutrition,
exercise, and early detection. In the book, I have a very convenient screening set of guidelines for both men and women, explaining what screening test needs to be done and at what age?
I also have a whole section on exercise and how this has been found to lower the risk of prostate, breast, and GI cancers. But clearly the weight of the book rests upon what types of nutritional
recommendations people can use to lower their risk.
As a general rule I would recommend people drink 1-2 cups of green tea every day. Also, people should consider consuming designer-type foods that contain combinations of algae and grass juices, as well as various herbs and antioxidants
I would also suggest people consume garlic regularly, consume 6- 8 servings of fruit and vegetables including cruciferous vegetables
every day. I would recommend everybody buy a juicer and juice
every morning. I have a whole section on juicing and various juicing recipes. I like to think of that as a fighter nutrient power drink which is really nice because people can do it every morning.
I think it s very important for me to point out that many times patients will come to me worried about cancer prevention and looking for nutritional advice to lower their risk, but they invariably will come back to me and tell me "I have never felt this good in my entire life." Initially, this was surprising to me, but it really shouldn't have been. When you body starts getting phytonutrients, that are always needed but seldom had, you are going to feel better. That is exactly what we see time and time again. So, this is not only a way of living longer and living healthier, it is a way of really making the most out of your life and having a level of energy and sense of well being that very likely you have never had because you have not been giving your body the proper nutrition.
In addition, I recommend people consume soy every day and cook with olive oil. If you look at the two highest countries where they consume Olive oil the most, Greece and Italy; they have one-third the breast cancer that we have in this country.
They also have lower rates of pancreatic cancer. What this suggests is that olive oil is critically important.
What makes it so important? We think the reason is that it contains antioxidants, it contains the phytonutrient called squalene. Squalene has been found to inhibit an enzyme that can lead to activation of the ras oncogene. This oncogene has been implicated in a variety of common cancers from lung cancer to colorectal cancer to pancreatic cancer. Perhaps, one of the ways that squalene works is by inhibiting this enzyme and preventing activation of that oncogene. We think that is one of the reasons people should be cooking with olive oil. So these are the major things to think about, but one really has to read the book to understand how important this is, as well as to become familiar with the research documenting the efficacy of these nutrients.
Passwater: Agreed! Thanks for writing the book and taking the time to chat with us about your cancer prevention program. For more details on Dr. Gaynor’s cancer protocols, please visit www.gaynoroncology.com.
© 1999 Whole Foods Magazine and Richard A. Passwater, Ph.D.
This article is copyrighted and may not be re-produced in any form (including electronic) without the written permission of the copyright owners.