Monday, March 5, 2007

Dr Dean Ornish Takes on Cancer

Ornish Takes on Cancer


Until Dean Ornish published his landmark study in 1990, most cardiologists saw heart disease as an inexorable part of old age and treated it largely palliatively, going to great lengths--even open heart surgery--to alleviate the pain and disability. What Dr. Ornish showed was that heart disease could be not only slowed down, but actually reversed with a plant-based diet and other lifestyle changes.[1] People learned they could quite literally take their life in their own hands and cure themselves of a debilitating life-threatening disease once thought incurable. The broader implication, of course, was that a plant-based diet could potentially prevent heart disease in the first place.

Largely ignoring the evidence Ornish presented, physicians of today, however, continue to talk of merely decreasing the risk of heart disease. As Dr. William Roberts, editor of the American Journal of Cardiology, points out "Pediatricians do not focus on decreasing the risk of mumps, measles, pertussis, or rheumatic fever. They focus on preventing these illnesses entirely. The same concept needs to be applied to atherosclerotic events."[2] Having demonstrated we could prevent and cure our number one killer without drugs and surgery, Ornish has now decided to take on killer number two, cancer.

Ornish knew that many plant foods--certain vegetables, tomato products, and soy--seem to reduce one's risk of prostate cancer and many animal foods--namely milk, cheese, eggs, fish[3] and other meat--have been shown to increase one's risk of dying from prostate cancer.[4] So Ornish wondered what would happen if he took patients who already had cancer and fed them a strictly plant-based diet--"predominantly fruits, vegetables, whole grains, legumes and soy products." As prostate cancer is the number one cancer among men, the Department of Defense provided funding for the study.

Ornish found 93 men with early biopsy-proven prostate cancer who volunteered to forgo radiation, chemo and surgery. He then randomized the cancer patients into lifestyle modification group, which included a strictly plant-based diet along with other healthy behaviors such as walking 30 minutes six days a week, or a control group which just watched and waited. A year later the results were tallied and published in the September 2005 issue of the Journal of Urology, the official journal of the American Urological Association.

By the end of the year-long study, six of the control group patients had dropped out because their tumors were growing. MRI's or diagnostic tests of cancer activity showed that their tumors were growing at such a rate that they decided they could wait no longer and opted for a combination of radical surgery, chemotherapy or radiation. Not one of the vegan diet group suffered the same fate. In fact, while on average cancer activity increased in the control group, as measured by PSA tests, the cancer markers decreased in the lifestyle modification group. By the end of the year the cancer growth rate, as measured by these tests, was highly significantly different between the two groups. For those on the plant-based diet, the cancer markers were going down.[5]

These results are nothing short of revolutionary. "This is the first randomized trial showing that the progression of prostate cancer can be stopped or perhaps even reversed by changing diet and lifestyle alone," Ornish told the Washington Post.[6] Cancer takes years--sometimes even decades--to grow. The fact that one might be able to make a difference this late in the game is astounding. If you smoke and get lung cancer, even if you choose to then finally stop smoking, it is very often too little, far too late. The cancer is already there and chances are it will still kill you. How could dietary changes have such a dramatic effect in people already diagnosed with cancer? Maybe a vegan diet boosts the cancer-fighting arm of your immune system? Ornish and his fellow researchers were intent on finding out.

The researchers took flasks of human cancer cells and incubated them with the blood taken from the cancer patients at the year's end. The blood serum taken from those that did nothing but watch and wait for a year only weakly inhibited the cancer cells, reducing their growth by only 9%. But the serum taken from those who spent the past year on the plant-based diet inhibited cancer growth 70%, almost an 8-fold difference! And Ornish found that the closer the patients stuck to the program, the better their results were--the more their own cancer seemed to be dwindling and the better their own blood was at killing cancer cells in the lab.

Dr. Ornish may have been naive to think that the cardiology profession would embrace his earlier work demonstrating as essentially unnecessary the majority of procedures by which cardiac surgeons derived their income. He was prepared, however, for the backlash from urologists, who's bread and butter include radical prostatectomies and brachytherapy (the implantion of radioactive pellets in through the rectum). One urologist attached a note to Ornish's paper trying to downplay the fact that the diet group's blood serum was so much more efficient in killing cancer cells. "Experimental serum seemed to contain something that differentially inhibited cell line growth but so what?" the urologist wrote. "Just because these serums were different does not mean that there were good. They might have also killed normal cells."

This shows how mired some physicians remain in the slash and burn mentality that too often typifies allopathic medicine. Ornish responded "Although it is true that chemotherapy and radiation may kill normal as well cancerous cells, we are not aware of any evidence that fruits vegetables, whole grains, legumes and soy products kill normal cells." He then of course goes on to cite all the evidence that in fact the reverse is more likely the case, as many of the phytonutrients in whole plant foods are actually protective of normal cells.[7]

Typical side-effects of conventional prostate cancer treatments are impotence and incontinence. What were the side-effects of the diet and lifestyle group? First off, a highly significant improvement in their cholesterol--dramatically decreasing the risk of these men dying from a heart attack while they were waiting for their cancers to disappear. The same diet that prevents heart disease also prevents cancer. And diabetes, and obesity, and hypertension, and constipation, diverticulitis, appendicitis--the list goes on and on. Yeah, but how was the quality of life of those undertaking these "intensive" lifestyle changes? I have often had patients jokingly ask if they are going to live longer on a healthy diet or is it just going to seem longer. But patients in this study dramatically changing their diet reported a marked improvement in quality of life overall. As Dean Ornish put it, "While fear of dying may not be a sustainable motivator, joy of living often is."[8]

[1] Ornish D, et al. 1990. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 336(8708):129-33.
[2] Roberts WC. 1999. Shifting from decreasing risk to actually preventing and arresting atherosclerosis. American Journal of Cardiology 83(5):816-7.
[3] Allen NE, et al. 2004. A prospective study of diet and prostate cancer in Japanese men. Cancer Causes Control 15(9):911-20.
[4] Snowdon DA, Phillips RL, and W Choi. Diet, obesity, and risk of fatal prostate cancer. American Journal of Epidemiology 120(1984):244-50.
[5] Ornish D, et al. 2005. Intensive lifestyle changes may affect the progression of prostate cancer. Journal of Urology. 174:1065-70.
[6] Stein R. Diet, exercise and reduced stress slow prostate cancer. Washington Post, August 11, 2005: A06.
[7] Ornish D, et al. 2005. Intensive lifestyle changes may affect the progression of prostate cancer. Journal of Urology. 174:1065-70.
[8] Ornish D. 2002. Statins and the soul of medicine. American Journal of Cardiology 89(11):1286-90.

No comments: