Cancer Recommendations and Considerations

Recommendations

❑ Eat a diet that includes grains, nuts, seeds, and unpolished brown rice. Millet cereal is a good source of protein. Eat wheat, oat, and bran. Cancer Recommendations.

❑ Eat plenty of cruciferous vegetables, such as broccoli, Brussels sprouts, cabbage, cauliflower, and spinach. Eat plenty of asparagus. Also consume yellow and deep-orange vegetables such as carrots, pumpkin, squash, and yams. Apples, berries (including blueberries, raspberries, and strawberries), Brazil nuts, cantaloupe, cherries, grapes, legumes (including chickpeas, lentils, and red beans), oranges, and plums all help to fight cancer. Most berries protect DNA from damage. Many of the plant pigments in red, yellow, orange, and blue fruits and vegetables are good sources of antioxidants. Green plants contain chlorophyll, which has been studied as a cancer fighter. Broccoli contains indole-3-carbinol (I-3-C), a compound known to eradicate many types of cancer cells on contact.

❑ Cook all sprouts slightly (except for alfalfa sprouts, which should be washed thoroughly and eaten raw).

❑ Eat onions and use garlic liberally, as it enhances the immune system and is a good cancer-fighter. Crushing garlic and then leaving it to rest for ten minutes before use seems to raise the levels of its cancer-fighting component, allyl sulfide. If you do not like the taste of garlic, take it in supplement form.


❑ Take ginger. Ginger suppresses nausea and therefore is an excellent treatment and preventive for the nausea and upset stomach that sometimes occurs with chemotherapy treatment. Ginger works best when taken with protein. In one study, the combination of the two resulted in a reduced use of medications for nausea and vomiting by cancer patients.

❑ Try to eat seven servings of whole-grain foods a day. Include at least five different types of grain foods in your diet each week.

❑ Eat ten raw almonds every day. They contain laetrile, which may have anticancer properties. Cancer Recommendations

❑ Eat as many tomatoes and tomato-based products as you can. Lycopene, an antioxidant agent in tomatoes, protects cells from oxidants associated with cancer. Eating a diet that includes plenty of tomatoes cuts the risk of cervical, lung, stomach, and prostate cancers. Preliminary reports suggest it may also prevent breast, colorectal, esophagus, mouth, and pancreatic cancers.

❑ Eat a lot of tart cherries, both fresh and in pies, jams, and sugar-free juice. They contain anthocyanins, antioxidants that may help prevent cancer and heart disease.

❑ Drink beet juice (from roots and greens), carrot juice (a source of beta-carotene), fresh cabbage juice, and asparagus juice often. Grape, black cherry, and all dark-colored juices are good, as are black currants. Also beneficial is apple juice, if it is fresh. Fruit juices are best taken in the morning, vegetable juices in the afternoon.

❑ Drink spring or steam-distilled water only, not tap water. Increased levels of contaminants in public water have been associated with an increased rate of lung, bladder, and breast cancers, as well as leukemia.

❑ Limit your consumption of dairy products. A little yogurt, kefir, or raw cheese occasionally is okay, but make sure that you are getting enough calcium, magnesium, and vitamin D from other foods or supplements. Calcium and vitamin D at levels slightly above the DRI have been shown to reduce the risk of all cancers in postmenopausal women. Since it is difficult to obtain these nutrients from food alone, it makes sense to take daily supplements, especially if you are eliminating dairy from your diet.

❑ Do not consume any of the following: peanuts, junk foods, processed refined foods, saturated fats, salt, sugar, or white flour. Instead of table salt, use sea salt, kelp, or a potassium substitute. If necessary, a small amount of blackstrap molasses or pure maple syrup can be used as a natural sweetener in place of sugar. Use whole wheat or rye instead of white flour. Do not consume anything containing alcohol or caffeine.

❑ Limit your intake of luncheon meats, hot dogs, or smoked or cured meats. Broiled fish or poultry are better choices. Fish is particularly important because it has not been associated with an increased risk of cancer, as beef has.

❑ A green drink that is a good master cleanser combines the juice of 2 organic lemons, 2 tablespoons pure maple syrup, ¼ teaspoon cayenne pepper, 1 ounce fresh wheatgrass juice, and 1 quart of distilled water. If fresh wheatgrass is not available, powdered Sweet Wheat from Sweet Wheat, Inc. is a good substitute.

❑ Take coffee enemas alternated with enemas made by adding 1 ounce of fresh wheatgrass juice to 1 cup of water. Do this daily to help the body eliminate toxins, if your gastrointestinal tract can handle it. Avoid enemas if you have colon cancer—an enema will hurt the inside lining of the GI tract. Wheatgrass enemas contain many nutrients and enzymes, and are used in many alternative clinics for cancer treatment. Also use cleansing enemas with lemon and water or garlic (Kyolic liquid) and water two or three times weekly.

❑ Do not take supplemental iron, unless your doctor has told you that you are anemic or require it for other reasons. If you are not iron deficient, the body naturally withholds iron from cancer cells to inhibit their growth. People with excessive iron in their blood have an increased risk of developing cancer. Excess iron may suppress the cancer-killing action of macrophages (cells that engulf and devour bacteria and other foreign invaders) and interfere with the activity of lymphocytes.

❑ Use only glass or stainless steel cookware and wooden cooking utensils.

❑ Get regular exercise. Cancer is less prevalent in physically active people. Exercise also helps to stave off depression and promotes oxygenation of the tissues.

❑ Check the radon level in your home. Radon is a radioactive gas that occurs naturally within the earth’s crust that has been classified by the Environmental Protection Agency (EPA) as a known carcinogen. Radon test kits are easy to find at hardware stores and are relatively inexpensive. If radon is found, sealing cracks and improving ventilation in the basement will usually improve the situation.

❑ Because of potential low-level radiation leakage, avoid microwave ovens. Do not sit close to television sets—sit at least eight feet away. Also avoid X-rays.

❑ Avoid chemicals such as hair sprays, cleaning compounds, waxes, fresh paints, and garden pesticides. Many chemicals promote the formation of free radicals in the body, which may lead to cancer. People with cancer can further weaken their immune systems by coming into contact with chemicals. The body then must expend energy trying to protect itself from the damaging chemicals instead of fighting the cancer.

❑ Use a shower head that removes the chlorine from your water. A product called Showerwise from Waterwise will do this.

❑ Do not take any drugs except for those prescribed by your physician.

❑ As much as possible, avoid stress. Learn relaxation and stress management techniques (such as meditation, visualization, deep breathing, and participation in support groups) to help you deal with those stresses you cannot avoid.

Considerations

❑ Many people with cancer have achieved good results with a macrobiotic diet.

❑ Some oncologists dissuade their patients from using dietary supplements when they are undergoing chemotherapy, radiation, or both, because of possible interactions. However, in a review of fifty clinical, peer-reviewed articles, involving over 8,000 patients, those who took supplements consistently had no problem with interactions. The nutrients most used by the cancer patients in this study were vitamins A, B complex, C, D, E, and K, selenium, cysteine, and glutathione. In a subset of these studies, survival was increased in those using supplements.

❑ If weight loss and muscle wasting are significant, you may have cachexia, which is associated with a high mortality, so early treatment is advised. More than 5 million people with a variety of diseases including cancer have this condition. It may be treatable with aggressive nutritional therapies such as intravenous or tube-feeding formulas.

❑ High doses of L-carnitine (6 grams a day for four weeks) were shown to increase energy levels and quality of life in patients with cancer.

❑ In a recent study, red meat and processed meats were associated with modest increases in cancer deaths, as well as death by any cause and death from heart disease. These findings were published in the prestigious medical journal Archives of Internal Medicine. The safest amount of red meat or processed meat was an average of ½ ounce per day. Thus, you can eat a serving (3 to 4 ounces) of these once a week without increasing your risk of developing cancer.

❑ Linoleic acid was once thought to be anti-carcinogenic, but a recent study suggests it is not. However, if you have been advised to lose weight, conjugated linoleic acid may be helpful. It helps to burn fat and induce a slow weight loss.

❑ German physician and cancer specialist Dr. Hans Nieper used fresh raw cabbage and carrot juice with excellent results. Dr. Nieper also used Carnivora, a substance derived from a South American plant, to fight cancer.

❑ New York based immunologist Dr. Nicholas Gonzalez developed a cancer treatment regimen that has been studied by the National Institutes of Health that incorporates changes in diet, nutritional supplementation, and toxinremoval systems, including coffee enemas.

❑ Various types of mushrooms can be good sources of vitamin D, B1 (thiamine), B2 (riboflavin), B3 (niacin), minerals, and amino acids. They have the ability to enhance the body’s immune system T cells that seek and destroy cancer cells. Shiitake, zhu ling, enoki, reishi, and maitake mushrooms have all been reported to have anticancer properties.

❑ Exceptionally low cholesterol levels have been associated with an increased risk of dying from cancer, possibly because people with lower cholesterol levels tend to consume more polyunsaturated fats, which may increase cancer risk.

❑ The rates of breast cancer among some women of Asian-American descent, particularly Japanese Americans, may be approaching those of white women, according to new research. University of Southern California researchers examined the trends in Los Angeles County and reported their results in the International Journal of Cancer. Women living in Asian countries have some of the lowest breast cancer rates of any group in the world, in contrast to women in the United States, where rates are among the highest in the world. Much of this has been linked to differences in lifestyle factors such as diet, exercise, body weight, and choosing to have children later in life (or not at all).

Ethnicity and national origin are among the strongest known predictors of breast cancer risk, the authors said. These factors are thought to affect a woman’s risk even more than those associated with menstrual periods and childbearing. But breast cancer rates have risen sharply in recent years in some Asian countries such as Japan, where women have adopted more “Westernized” lifestyles. In fact, breast cancer is expected to soon become the most common cancer among women in Japan, the authors said.


❑ A daily dose of seven to ten servings of fruits and vegetables can reduce cancer risk by about 30 percent. Eating smaller amounts-5 servings a day—does not reduce the risk. In a study published in the Journal of the American Medical Association, women who had breast cancer and were in remission who ate 5 servings of fruits and vegetables a day did not have a reduced rate of recurrence of the disease. Still, many phytochemicals found in plant foods are currently being studied for anticancer properties, including:

• Lutein, one of the carotenoids, is under investigation as a possible anticancer nutrient. Good sources of lutein include dark, leafy greens and broccoli.

• Genistein and diadzein, two isoflavones found in soy, act as antioxidants and may protect against most forms of cancer, especially prostate cancer, breast cancer, leukemia, glioblastoma multiforme, and bladder cancer. Soy’s soluble fiber reduces the risk of many digestive system cancers, such as colon and rectal cancer. The water-absorbing fiber may dilute intestinal carcinogens and usher them out of the body, as well as spur growth of bifidobacteria, the good bacteria that help prevent colon cancer. Mega Soy Formula from Prolongevity is a good supplement that contains a substantial amount of genistein and other isoflavones that help to fight cancer.

Although they may reduce risk of cancer, because of their estrogen-like properties, isoflavones may actually increase the risk of some kinds of cancer. A new review says phytoestrogens may have both a protective role and a stimulatory role in breast cancer cell growth depending on several factors, including at what age they’re consumed and whether they’re consumed as food or as supplement.

• D-glucaric acid, a phytochemical found in broccoli, Brussels sprouts, and cauliflower, has shown evidence in several clinical studies of reducing the incidence of cancers of the breast, lung, liver, and skin. D-glucaric acid is also available in supplement form combined with calcium (calcium D-glucarate).

❑ A four-year study conducted at the University of Illinois College of Medicine showed that high levels of antioxidants have a protective effect against cancerous tumors. However, there have been some mixed results from other studies. Alpha-tocopherol has been shown to protect against tumors, while in one study beta-carotene and vitamin A had no effect. In another study, large amounts of vitamin E had no significant effect, but seemed to trend toward increasing risk of prostate cancer.

❑ Calcium may prevent precancerous cells from becoming cancerous.

❑ Inositol hexaphosphate (IP6), a form of the B vitamin inositol, is gaining attention for its ability to aid in the prevention and treatment of cancer. It is found naturally in whole grains, beans, lentils, pork, veal, citrus fruits, and nuts. Evidence has shown that it may not only shrink tumors, but also prevent tumor growth.

❑ Niacin may play a major role in the prevention and treatment of cancer.

❑ The lower the serum concentrations of the mineral selenium, the greater the associated risk of several types of cancer, including leukemia, esophageal, lung, colorectal, prostate, breast, and ovarian cancers. However, according to the National Institutes of Health’s Office of Dietary Supplements, the tolerable upper level for adults is 400 micrograms (mcg) per day. Selenium supplementation should be discussed with a physician. Dietary sources of selenium include Brazil nuts, tuna, flounder, pork, turkey, pasta, pinto beans, and navy beans.

❑ Studies have shown that supplementation of vitamins A, C, and E can decrease the effect of lipid peroxidation, or the oxidation of body fats, which leads to the creation of free radicals in the body.

❑ Research is under way to determine the effects of vitamin D on cancer. Early findings suggest that daily exposure to a limited amount of sunlight (a good source of vitamin D) may reduce the risk of breast, colon, and prostate cancers. If sunlight is not available all year round, taking a vitamin D supplement is just as effective.

❑ Gamma E Tocopherol from Prolongevity is a vitamin E supplement containing gamma-tocopherol, delta-tocopherol, alpha-tocopherol, and beta-tocopherol—all natural forms of vitamin E. This product offers powerful protection against dangerous free radicals.

❑ Nutritional supplements and better dietary habits offer great support to cancer patients who are receiving chemotherapy and/or radiation, or who are in remission. Taking shark liver oil prior to radiation therapy has been shown to protect healthy tissue against injury from the procedure. Shark liver oil contains alkylglycerols (AKGs), vitamins A and E, omega-3 fatty acids, trace minerals, and squalene. A study published in the European Journal of Cancer in 1997 reported that glutamine can reduce adverse side effects associated with chemotherapy.

❑ Some types of cancer are treated with chemotherapy, which can apparently cause cancer to go into remission. Cancer chemotherapy is the administration of highly toxic medications meant to kill cancer cells. Most chemotherapy medications destroy normal cells in the process, causing adverse side effects including hair loss, extreme nausea, vomiting, fatigue, weakness, sterility, and damage to the kidneys and heart. Certain nutrients may help the body avoid some of the damage done by this treatment, among them vitamin B6 (pyridoxine), coenzyme Q10, glutathione, and vitamin C.

❑ In some cases, radiation therapy may be recommended. This involves aiming concentrated X-rays directly at a tumor to kill the cancerous cells. Radiation therapy too has unpleasant side effects, including fever, headache, nausea and vomiting, and loss of appetite.

❑ Moderate use of low-dosage aspirin may aid in killing tumor cells. The New England Journal of Medicine found that patients who had been treated for colorectal cancers had a lower rate of recurrence when they took a daily dose of aspirin and that aspirin reduces the growth of polyps in the colon that may lead to cancer.

However, the Nurses’ Health Study at Boston’s Brigham and Women’s Hospital came to the unexpected conclusion that women who take aspirin twice daily increased their risk of getting pancreatic cancer.

❑ Non-small-cell lung cancers, which account for most cases of lung cancer in the United States, may be treated with porfimer (Photofrin), gefitinib (Iressa), and gemcitabine (Gemzar) in combination with cisplatin. Paclitaxel (Taxol) taken in combination with the commonly used cancer drug cisplatin (Platinol) is still being investigated.

❑ Docetaxel (Taxotere) is a drug approved for treating non-small-cell lung cancer that does not respond to cisplatin-based chemotherapy.

❑ Doxorubicin (Adriamycin) is a potent chemotherapeutic drug used for treating many forms of cancer. Patients on this drug should avoid curcumin (turmeric).

❑ The genetically engineered virus ONYX-015 is designed to infect and kill cancer cells without harming healthy ones. It is under study. Other drugs undergoing testing as cancer therapies include:

• Angiostatin and endostatin, promising anticancer agents that stop the growth of new blood vessels to feed tumors.

• BR96-DOX, a drug that zeroes in on cancer cells, leaving the healthy cells alone. Its active ingredient is doxorubicin, a proven chemotherapy cancer-killing substance.

• Hydrazine sulfate is a monoamine oxidase (MAO) inhibitor available as a dietary supplement that may help offset the inability to eat, fatigue, weight loss, and muscle deterioration often associated with cancer. It also has been studied for over three decades as a treatment for cancer itself. Possible side effects include nausea and vomiting, tingling, loss of feeling, and inflammation of the nerves in the hands and feet, and irregularities in glucose level, alkaline phosphatase, and liver function tests have been reported. Dizziness, weakness, drowsiness, and itching may also occur.

• Interferon and interleukin-2 (IL-2) were the standard treatment for metastatic kidney disease. Now two drugs replace this therapy: sunitinib, which inhibits several cellular proteins that promote growth of blood vessels in tumors; and temsirolimus, which targets another cellular protein that regulates the growth of tumor cells.

❑ Two preventive vaccines have been approved for cancer. One prevents the hepatitis B virus, which can cause liver cancer. The other is a vaccine against the human papillomavirus (HPV) types 16 and 18, which are responsible for many cases of cervical cancer. Effective cancer treatment vaccines are under investigation, including one for non-Hodgkin’s lymphoma and another for advanced non-small-cell lung cancer.

❑ Hyperthermia, a procedure in which body tissue is exposed to extremely high temperatures (up to 106°F), may be effective against tumor cells and can be used alone or in combination with radiation therapy and other therapies. Researchers believe that the heat may damage tumor cells or deprive them of the nutrients they need to live. It is important that hyperthermia is applied in a safe way under a physician’s care.

❑ Conventional therapies (chemotherapy, radiation, and surgery) may not be as effective at fighting cancers of the lung, pancreas, liver, and bone, and advanced colon and breast cancers, as they are at fighting other types of cancer.

❑ The hormone dehydroepiandrosterone (DHEA) is believed by some to help prevent cancer by blocking an enzyme that promotes cancer cell growth. A form of DHEA, 7-keto DHEA, unlike DHEA itself, is not converted into testosterone or estrogens. It may be a better option for those at high risk for breast, endometrial, uterine, and prostate cancers. However, according to the American Cancer Society, available scientific evidence does not support claims that DHEA supplements are safe or effective for treating cancer. Caution is advised in their use in people who have cancer, especially types of cancer that respond to hormones, such as certain types of breast, prostate, and uterine cancer. People younger than thirty may run the risk of suppressing the body’s natural production of DHEA if they take DHEA supplements.

❑ Studies have shown grape seed extract to not only enhance the development of normal cells, but also to inhibit abnormal cell growth.

❑ Research has shown hyperbaric oxygen therapy (HBOT) is effective when used in addition to conventional treatment for the prevention and treatment of osteoradionecrosis, a term for delayed bone damage caused by radiation therapy. There is also some evidence suggesting HBOT may be helpful as an additional treatment for soft tissue injury caused by radiation. However, there is no evidence that HBOT cures cancer.

❑ Research is ongoing regarding the anticancerous effects of the hormone melatonin, which is produced by the pineal gland. It has strong antioxidant effects and acts as a scavenger of free radicals that induce DNA damage. Melatonin may inhibit tumor growth by interaction with interleukin 2 (IL-2) and seems to have a beneficial effect particularly on endocrine tumors. The synthetic form is preferred since the natural form, recovered from animal pineal glands, could contain harmful viruses. Melatonin can be used to good effect on various types of tumors, under supervision of a physician.

It seems to be effective in fighting cancers of the male and female reproductive system, breast, and prostate. Studies are still needed to determine the effects of long-term use of melatonin in supplement form. Some recent studies have found that people who work night shifts may be at increased risk for cancer, which could be linked to melatonin levels in the body. Study results regarding the effect of melatonin supplements on survival and quality of life in people with cancer have been mixed, and further research in this area is needed.

❑ In older studies shark cartilage has been shown to be helpful for certain types of cancer, including cancer of the breast, cervix, pancreas, and prostate, as well as Kaposi’s sarcoma, a type of skin cancer.

It suppresses angiogenesis (the development of new blood vessels), depriving cancerous tumors of nourishment and, often, causing them to shrink and die. Although some laboratory and animal studies have shown that some components in shark cartilage have the ability to slow the growth of new blood vessels, these effects have not been proven in humans. The few small clinical studies of shark cartilage products published more recently have not shown any benefit against cancer. Further clinical trials of the supplements and of a purified cartilage extract are currently under way.

❑ Shark liver oil is a rich source of alkylglycerols, chemicals that may have anticancer properties. Alkylglycerols are also found in human bone marrow and in breast milk. Other chemicals in shark liver oil being studied against cancer are squalamine and squalene.

❑ The single most avoidable cancer risk is smoking. Cigarette smoke is made up of more than 4,000 chemicals, including 43 that are known to cause cancer. It also contains the poisonous gases nitrogen oxide and carbon monoxide. Lung cancer was a rare disease until the twentieth century, when cigarette smoking became widespread. In 2009 there were an estimated 219,440 new lung cancer diagnoses and 159,390 deaths. Besides lung cancer, smoking can cause cancers of the cervix, kidney, pancreas, and stomach. The cancerous effects of smoking are multiplied by alcohol consumption, and the two are frequently used in combination.

Research suggests that if you quit smoking when precancerous signs are found, damaged lung tissue may return to normal, oftentimes within five years. Statistics show that 1 out of 5 women diagnosed with lung cancer has never smoked, compared to 1 out of 10 men. Regular exposure to secondhand smoke can increase a nonsmoker’s chance of getting cancer by 20 to 30 percent.

❑ There have been some claims that dairy products increase the risk of cancer. However, it is more likely that it is fat that is the problem, not milk. Almond, rice, and soy milk are good low-fat alternatives.

❑ A study published by the American Journal of Epidemiology has disproved suggestions that there is a link between lactose and/or galactose (sugars found in milk) and ovarian cancer.

❑ Obesity in men may cause or contribute to colon and rectal cancer; in women, it has been linked to gallbladder, cervical, uterine, and breast cancer. Overweight women are more likely to develop cancer of the uterine lining than other women and tend to do poorly if they develop breast cancer. Fat affects the level of sex hormones in the body. Hormones produced by the adrenal glands are converted into estrogen in fat tissue, so the greater the amount of fat present, the higher a woman’s estrogen levels are likely to be. Estrogen stimulates cells in the breast and reproductive system to divide.

❑ Some people believe that fluoride (which is in toothpaste, tap water, and every product made with tap water) may be a risk factor for cancer.

❑ The incidence of leukemia among children who were breast-fed has been found to be significantly lower than that among bottle-fed children.

❑ A group of seventy-five Environmental Protection Agency (EPA) experts ranked pesticide residues among the top three environmental cancer risks.

❑ Men who undergo vasectomy do not increase their prostate cancer risk, according to researchers in the Journal of the American Medical Association (JAMA). There had been some concern about vasectomies and prostate cancer because two 1990 studies reported an increased risk of prostate cancer after vasectomy.

❑ High-voltage power lines have been under study as a possible contributor to cancer. Researchers at the National Institute of Environmental Health Sciences (NIEHS) have reported that, while it is a possibility, it is not likely.

❑ Since women have been having Pap smears, the mortality rate for cervical cancer has dropped by more than 70 percent. However, Pap smears are not always accurate. Some tests show promise for improving the accuracy of Pap tests. AutoPap is a computerized screening test designed to improve the Pap test’s accuracy. ThinPrep is another variation on the Pap test. It utilizes a different method of collecting the cells that can make it easier to detect cell abnormalities. The FDA has approved an HPV DNA test that can detect the presence of human papillomavirus (HPV), which is associated with cervical cancer. Women over age thirty and who are at higher risk for cervical cancer may want to discuss these tests with their doctors. Research on other types of tests to detect cervical cancer is ongoing.

Irritable bowel syndrome does not increase the risk of colon cancer.

❑ Men who receive either of two kinds of treatment for testicular cancer appear to be at increased risk for leukemia. A recent study highlighted those getting radiation treatment and Cisplatin, a standard cancer chemotherapy agent. The study also noted that the higher the dosage, the greater the risk. Researchers are quick to point out that the benefits of both treatments far outweigh the small increased risk of leukemia.

❑ Most people are unfamiliar with head and neck cancer, yet worldwide more than 500,000 people are diagnosed with these cancers every year. According to the National Cancer Institute (NCI), men are three times more likely than women to be diagnosed with head and neck cancer and almost twice as likely to die from their disease. Patients with head and neck cancer suffer a high mortality rate. Head and neck cancer does not include brain tumors. Treatment includes radiation therapy, which is often implemented following surgery. However, radiation therapy can cause adverse, even lethal, side effects. Lethal radiation necrosis (tissue death) in the brain is one potential side effect of radiation therapy. Also, stroke rates increase by five times in people who have undergone radiation therapy for head and neck cancer.

Stroke is the official cause of death among many people who have had head and neck cancer who later die after radiation therapy treatments. For this reason, cancer cure statistics can be misleading. Even though radiation therapy may cure cancer, nonrelated cancer deaths seem to be a long-term side effect of radiation. Although more people with cancer are now living beyond five years after diagnosis, premature death can be a direct result of toxic therapies used to eradicate cancer.

We do not recommend that people with head and neck cancer refuse radiation therapy. As it often buys years of extra life. They should, though, take extra precautions to reduce their risk of stroke.

❑ A small portion of colorectal cancers are known to be caused by inherited gene mutations. Hereditary nonpolyposis colon cancer is caused by changes in genes that normally help a cell repair faulty DNA. Cells must make a new copy of their DNA each time they divide into two cells. Sometimes errors are made in copying the DNA code. Cells usually have DNA repair enzymes, but some mutations in these enzymes such as MLH1 may allow DNA errors to go uncorrected. These errors will sometimes affect growth-regulating genes, which may lead to cancer. Genetic tests are available that can detect gene mutations associated with some inherited gene mutations.

❑ Cancer has been reported to be badly underdiagnosed. In one autopsy review of those found with malignancies, over half of the deaths were caused by undiagnosed cancer.