Mainstream Nutritional Science and the Unconventional Nutritional Cancer Therapies
Unconventional Nutritional Approaches to Cancer–An Overview
In any discussion of the unconventional nutritional approaches to cancer, it is useful to develop a typology that clarifies the basic differences between these various approaches. For example:
Most unconventional nutritional cancer therapies are vegetarian, but some are not.
Some nutritional cancer therapies involve primarily raw foods (such as the Gerson diet and the Hippocrates wheat-grass therapy), while others (such as macrobiotics) involve primarily cooked foods.
Many nutritional cancer therapies use nutritional supplements as well as diet (such as the Livingston program), but others (such as macrobiotics) do not use supplements.
Some nutritional cancer therapies place major emphasis on the inclusion of specific foods known in scientific studies to have anticancer effects (such as Keith Block’s nutritional program), while others do not.
Some therapies place emphasis on different foods believed in traditional medicines to have anticancer effects, but these recommendations–as in macrobiotic and Ayurvedic cancer diets–may often be directly contradictory.
Some therapies (such as the Gerson diet) place a major emphasis on low sodium, high potassium foods, while others (such as macrobiotics) do not.
Some therapies (such as the Gerson diet) place a stringent emphasis on organic foods, while others do not.
Some therapies are protein-restrictive, while others are not.
Some therapies include detoxification measures (such as the Gerson and Hippocrates program enemas), while others do not.
Some therapies are purely nutritional, while others integrate nutritional, psychological, spiritual, immunosupportive, and other forms of treatment.
From the great variety of unconventional nutritional approaches, certain commonalities emerge. Most of the alternative nutritional approaches to cancer involve fresh, whole foods eaten in nutritionally balanced combinations with a strong emphasis on a primarily vegetarian diet. Fundamentally, they shift the diet in directions known from epidemiological studies to be helpful in lowering the incidence of many of the common cancers. If they sometimes recommend drastic dietary changes, it is because reversing an established cancer is obviously a much more difficult proposition than preventing the development of cancer.
A critical distinction for cancer patients exists between nutritional programs known to be nutritionally adequate and other programs which apparently work, when they do, by the cancer-inhibiting effects of selective nutrient restriction (see chapter 11). These latter approaches, like chemotherapies, involve a real element of danger: they assume that the cancer is more vulnerable than the host organism to nutrient restriction, and that the cancer will be controlled before the patient loses too much weight.
In reality, different patients respond very differently to all nutritional cancer therapies, including both those known to be nutritionally adequate for most people and those that are severely nutrient-restrictive. A specific cancer pa- tient may find even the nutritionally adequate diet personally inadequate for him, as shown by continuing weight loss without stabilization at some healthy level. Yet another person with cancer may stabilize at an adequate, if low, weight onêa quite restrictive diet. But the restrictive diets clearly involve additional risk.
These are excellent reasons why intensive nutritional therapies for cancer should, in the ideal world, be medically supervised by broad-minded, nutritionally trained oncologists who are aware of how to modulate a nutritional program according to the individual patient’s responses and nutritional needs. One of the unfortunate realities is that such broad-minded nutritionally trained oncologists are extraordinarily rare. So the patient is usually left to his own devices, or to supervision by a physician with at best broad practical nutritional experience. The tragic cases are when self-supervision, or supervision by an untrained practitioner, leads to progressive weight loss, decisive weakening of the patient, and death.
The Problem of Weight Loss in Nutritional Cancer Therapies
I want to tell the story of Luis, a wonderful South American man with metastatic prostate cancer who came as a participant to the Commonweal Cancer Help Program. He had done extremely well with the support of a gifted mainstream doctor using a hormonal therapy and a macrobiotic program. His cancer was in remission for several years. One day I had a call from the macrobiotic practitioner who had taught Luis the macrobiotic diet. He described how, with a recurrence of his cancer, Luis had gone to a Mexican clinic where he had been put on a highly restrictive raw foods diet. He grew progressively weaker, but his symptoms of physiological decline were interpreted to him by the staff at the clinic as “healing crises.” He finally grew so weak from the diet that he died. The macrobiotic practitioner was distraught. It was, he said, a profound lesson to him about the dangers of some nutritional therapies. While he believed that “healing crises” (in holistic health theory, the temporary augmentation of some symptoms as the body detoxifies and begins to recover) are a reality in many holistic treatments, he saw how destructively the term had been used at the Mexican clinic where Luis had gone: how in fact this nutritional program had cost Luis his life.
The experience of Luis is not a common one. But it is not, unfortunately, entirely uncommon. I also knew the wife of a senior American scientist, who described to me how her husband, with a liver cancer, had gone on the Hippocrates wheat-grass program. There are many people with cancer who believe that the Hippocrates program has been a benefit to them, particularly as a short-term detoxification program. But this man followed the highly restrictive raw foods diet rigorously despite the fact that with his particular physiology and condition he experienced progressive weight loss without any sign of stabilization. His wife had supported him wholeheartedly in undertaking the program, given that conventional medicine had nothing to offer him. But as he became progressively more emaciated, she became more and more concerned. She was convinced, she told me, the diet was a significant contributor to his death.
In still another case with which I am familiar, a man with prostate cancer and his woman partner undertook a macrobiotic diet together. The man did very well on the macrobiotic program, but his partner, seeking in solidarity to eat exactly what he ate, progressively lost weight until friends became very concerned for her. The friends convinced her that she simply was not physiologically the same as her mate and that she needed to broaden her diet. She did so, while remaining primarily macrobiotic, and stabilized at a healthy weight.
My point is that nutritional approaches to cancer, while characteristically nontoxic and generally health-promoting, can be dangerous if not appropriately supervised or if not undertaken with self-awareness and common sense. The razor’s edge with nutritional therapies, as I said in chapter 11, is with those nutrient-restrictive therapies which–like chemotherapies–require finding the margin where life is sustained but the cancer is, in theory, inhibited. This usually requires a carefully supervised course of treatment. The critical question appears to be whether or not an individual’s weight stabilizes–often at his college or high-school weight–after a few months on the program. If there is no stabilization, and weight loss is progressive, the patient is almost certainly on a diet that is nutritionally inadequate.
On the other hand, it is important to point out the fact that moderate weight loss is what many cancer patients need, especially in breast cancer and other cancers in which obesity is a known risk factor. Chapter 11 reviewed in some detail the reasons why caloric restriction may be helpful both in primary prevention and in preventing recurrence in some cancers. Nor should we be surprised that a given nutritional therapy can produce positive results for one person and negative results for another. Just as different people with the same cancer have different responses to a specific chemotherapy, the same is true with nutritional approaches. Because few clinical trials of these therapies have been conducted, both the physician and the patient should carefully watch for any changes brought about by the diet.
Ian Gawler’s Approach to Anticancer Diets
Ian Gawler, an Australian veterinarian, has developed a good example of a reasoned integral approach to cancer that utilizes diet, meditation, and some of the other therapies that we have already discussed. Following the amputation of his leg and the development of inoperable and highly visible chest wall tumors extruding from his chest, Gawler recovered from an advanced metastatic osteosarcoma. He worked with the late Ainslie Meares, an Australian psychiatrist, who wrote up his recovery as an example of the effects of intensive meditation. Subsequently, Gawler became one of the leading exponents in Australia of holistic approaches to cancer. Although his nutritional perspective is not well-known in the United States, he serves as an example of someone who developed a highly intensive holistic nutritional-psychological program based on sane principles and inferences from the nutritional and psychological literature.
To begin with, Gawler makes a sensible overview of the main dietary options. There are, he suggests, basically four alternatives:
First, you may not wish to make any changes in your diet. This, as Gawler emphasizes, is fine for some people. And it is true that exceptional recoveries from cancer do take place without any dietary change. At the same time, as Daan C. Baalen and Marco J. de Vries of Erasmus University found in their study of remissions from cancer in the Netherlands, dietary change is one of the most frequent concomitants of spontaneous regression of cancer.1
Second, you may adopt a maintenance diet that is basically a healthy, whole-foods diet that avoids foods and substances known to be injurious to health. This is a beneficial step and, as Gawler points out, a major one for some people who have eaten poor diets in the past. Simply starting to eat a healthy whole-foods diet–such as that recommended by the National Academy of Sciences–can make a major contribution to health.
Third, you may develop an individualized nutritional program of any level of vigor and intensity. This is what Gawler himself finally did, based on experience he developed after following the Gerson diet for 3 months. The sensitivities he developed to foods that helped or hurt him on the Gerson diet led to an awareness of how to individualize his own nutrition optimally.
Fourth, you can commit yourself to one of the intensive programs, such as the Gerson diet, macrobiotics, or the Bristol diet program, preferably seeking professional help to undertake it.2
From his years of dietary experimentation, Gawler proposed four basic principles for nutritional cancer therapy: (1) the body should be detoxified; (2) any vitamin and mineral imbalances need to be corrected; (3) digestion should be restored and the diet made up of only fresh, vital, pure, and suitably prepared food; and (4) the patient needs to develop and maintain a positive attitude, both in general and toward his diet in particular.3 Let us discuss each of these briefly.
It is fascinating that the concept of detoxification–the removal of existing toxins from the system–and the avoidance of introducing new toxins–have virtually no credibility in mainstream nutrition despite the fact that the carcinogenic impact of toxic substances in human biology is well known. Yet detoxification is a fundamental practice in many forms of traditional medicine, especially naturopathic medicine. Writes Gawler:
It makes good sense to remove any toxins in the system and then avoid introducing any new sources of toxic material. The latter is easier than the former, and can be done by avoiding those things incriminated as having an increased risk of cancer.
Removing toxins from the body is not such a simple business in theory or practice. It is certainly more open to medical debate. Again, these principles do work, and I suggest they can be validated. … What is not so reasonable is the emphasis some patients put on detoxifying [e.g., through excessive emphasis on enemas]. Perhaps this is because of feelings of uncleanliness that sometimes accompany disease, but it disappoints me to see some people seeming to delight in detoxifying through cleansing and purging in a rather violent way. Detoxifying is not just cleansing the bowels with gusto! It is a thorough spring cleaning for the whole body and can be done gently.4
Gawler recommends “eating a lot of fresh, vital foods [to] get the process in motion.” He agrees with Gerson on the use of freshly prepared vegetable and fruit juices, but does not agree that these juices are always needed hourly 12 times a day. He also accepts Gerson’s concept that raw organic liver juice may help build the blood. He also found Gerson’s coffee enemas effective as a liver stimulant–a point to which I will return in my discussion of Gerson.
Nutritional Supplementation in Vitamin and Mineral Imbalances
As I mentioned in chapter 11, there is good evidence that modern American diets are often nutritionally unbalanced, that cancer patients specifically often demonstrate nutritional imbalances both prior to and after development of cancer, and that, in laboratory and animal experiments, specific nutrients can slow, stop, or reverse the progress of some cancers. This research raises the issue of whether cancer patients should use nutritional supplements. This, Gawler correctly concludes, is one of the most difficult nutritional areas in which to say anything definitive. His view is that the Gerson diet and some other intensive regimens provide very high levels of needed nutrients in natural forms and balances.
But many cancer patients on intensive programs still use supplements despite the fact that the proponents of the therapies often, in principle, recommend against them. Gawler tried megavitamin therapy but found it did not help him, although “at specific times I have felt the need for specific supplements and benefitted from them … supplements are a difficult question, the one I find the hardest to be clear about and I make no definite recommendations.”5
Digestion and Fresh Food
With regard to restoring the digestion and switching the diet to fresh, vital, pure, and suitably prepared food, there is good evidence for the higher nutrient values of such foods. At the same time, one rarely finds mainstream physicians or nutritionists speaking in these essentially holistic terms about the quality of food patients should eat. Gawler observes:
Here again the idea of supplementing the digestive functions is medically questionable. I find this easier to put forward [than recommendations for nutritional supplements] as there is little doubt that most cancer patients initially do have an impaired digestion. Gerson recommended supplementing stomach acid and pancreatic enzymes. There have been several claims that pancreatic enzymes can actually attack cancer cells and digest them. I find the evidence for this to be sketchy. It is hard to imagine such supplements doing harm, however, and there is a body of circumstantial evidence which suggests that they might do good. I took them while I was on Gerson’s therapy but they were one of the first things I discontinued.6
Positive Attitude toward Food
The idea that it is important to develop and maintain a positive attitude in general and toward a healthy diet in particular is virtually never discussed in mainstream nutrition but is one that Gawler emphasizes:
This whole area of diet is full of excitement, controversy and the definite prospect of being helpful. It is essential to be clear in your own mind as to the relevance it has for you. You should feel good about your choices. It is very necessary to think about the whole area and come to definite conclusions. In the final analysis, food should be a happy thing. You should be able to sit down before it, give thanks for what you have to eat, know that it is appropriate for your situation, and eat with a smile on your lips and a song in your heart!7
In short, the four basic nutritional-psychological concepts that Gawler discusses–which are broadly representative of many alternative cancer therapies–are not inconsistent with any scientific evidence but do go beyond science in proposing that such a diet and attitude may assist in recovery from cancer.
What is particularly valuable about Gawler’s contribution to the field of holistic nutritional-psychological approaches to cancer is that his position is not doctrinaire. He personally has experienced a documented recovery from an advanced cancer from which he was expected to die. He achieved his recovery while using intensive nutritional and psychological measures. And yet he did not come out of this recovery experience–as many understandably do–a true believer and zealot for a specific nutritional program as the answer for everyone with cancer. Rather, he takes a balanced and at the same time very vigorous perspective on nutrition as a key for some people to cancer recovery. He carefully notes that detoxification is not discussed in the contemporary mainstream medical literature, and that nutritional supplementation represents a problematic area. He allows everyone room to choose his own type and level of nutritional intervention. He personally undertook one of the most rigorous nutritional programs–the Gerson diet–and then continuously modified it until he reached an individualized program.
Keeping in mind Gawler’s example of a flexible and reasoned approach to nutrition in cancer, in the next four chapters we look at some of the major nutritional therapies.
1 Daan C. van Baalen, Marco J. de Vries, and Marjolein T. Gondrie, “Psycho-Social Correlates of ‘Spontaneous’ Regression in Cancer.” Monograph, Department of General Pathology, Medical Faculty, Erasmus University, Rotterdam, the Netherlands, April 1987, 6.
2 Ian Gawler, You Can Conquer Cancer (Melbourne: Hill of Content, 1986), 99.
3 Ibid., 90-1.
4 Ibid., 91.
5 Ibid., 97.
6 Ibid., 97.