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CNM NUT 2 S2 - KZ > 16. CANCER SUPPORT > Flashcards

16. CANCER SUPPORT Flashcards

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1
Q

What is the (short) definition of cancer?

A

The uncontrolled division of abnormal cells that grow beyond their normal boundaries.

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2
Q

What are the features of cancer? (10)

A
  • Avoids immune destruction
  • Evades apoptosis
  • Insensitive to anti-growth signals
  • Limitless replicative potential
  • Proliferation is sustained
  • Angiogenesis is sustained
  • Able to metastasise
  • Has inflammatory tumor protectors
  • Has genome instability & mutation
  • Has reprogrammed energy metabolism (uses glycolysis)
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3
Q

What genes play a role in cancer pathogenesis & how? (5)

A

VDR - allows immune system evasion. Vit D is anti-proliferative and pro-apoptosis.

MTHFR - altered DNA synthesis and methylation.

CYP1A1 - altered xenobiotic metabolism.

CYP1B1 - altered oestrogen metabolism

  • BRCA1 & BRCA2 - allows uncontrolled growth as they are tumor suppressor genes which normally regulate division and induce apoptosis.
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4
Q

Mutations of these genes are associated with cancer of which organs?

A

BRCA1 & 2 - Breast
VDR - Breast, prostate, lung
MTHFR - Breast, prostate, lung
CYP1A1 - Lung
CYP1B1 - Prostate

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5
Q

What are the stages of cancer?

A

0 - Earliest form
1 - No spread
2 - Local tissue
3 - Lymph nodes
4 - Distant spread

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6
Q

What are the causes and risk factors for cancer?

A
  • Genetic mutations
  • Hyperglycaemia (from refined carbohydrates)
  • Obesity & chronic excess calories
  • Chronic inflammation
  • High Omega 6:3 ratio
  • Low Vitamin D
  • Aspartame
  • Dairy Products
  • High temperature cooking
  • Alcohol
  • Smoking
  • Xenobiotics
  • Dysbiosis
  • Stress
  • Disrupted sleep
  • Nocebo effect
  • Saturated fat
  • Poor Methylation
  • Nutrient deficiencies
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7
Q

Are genetic mutations of key genes deterministic for cancer? Why?

A

Inherited mutation, but epigenetics can switch genes on and off so influence of genes is not deterministic.

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8
Q

How does hyperglycaemia cause cancer? (5)

A
  • Increases inflammation & oxidative stress causing DNA damage
  • Increased insulin increases IGF-1 which stimulates cell proliferation
  • Promotes hyperactivation of mTOR at expense of AMPK
  • Tumours express insulin receptors causing growth
  • Cancer cells use glucose in glycolysis. This in turn produces lactate causing an acidic environment favoured by cancer.
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9
Q

How does obesity & chronic excess calories cause cancer? (4)

A
  • Increases oestrogen production from adipose tissue.
  • Increases inflammation & oxidative stress.
  • Increases leptin which causes cell proliferation
  • Decreases Adiponectin which is protective
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10
Q

What transcription factor promotes tumour progression? How is it activated (4) and what is it inhibited by (2)

A

NF-kB promotes every step of tumour progression and is activated by:
- Inflammatory cytokines
- Viruses
- LPS
- Radiation / Chemotherapy
Fibre & polyphenols increase SCFAs to inhibit NF-kB

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11
Q

How does a high Omega 6: 3 ratio contribute to cancer?

What is the ideal ratio?

A

It increases proliferation, angiogenesis and inflammation.

Ideal ratio is 1:1 - 2:1

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12
Q

How does low Vitamin D contribute to cancer?

A

Vitamin D regulates cell cycle, induces apoptosis, promotes cell differentiation and is anti-inflammatory.

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13
Q

What organ is Aspartame associated with for causing cancer?

A

Liver

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14
Q

How do dairy products contribute to cancer?

A

They contain Insulin-like Growth Factor (IGF) which is a cancer promoter.

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15
Q

How does high temperature cooking contribute to cancer?

A

High temperature cooking generates: Heterocyclic Amines (HCAs), Polycyclic Aromatic Hydrocarbons (PAHs) and N-Nitroso Compounds.
Also, acrylamide forms when starchy foods are cooked to over 120 degrees.

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16
Q

How does alcohol contribute to cancer?

A

Acetaldehyde is produced in alcohol metabolism by the liver

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17
Q

How does smoking and vaping contribute to cancer?

A
  • Smoking is toxic and pro-oxidant. It contains 60 carcinogens and heavy metals (e.g. cadmium).
  • Vapes contain formaldehyde and arsenic.
  • Nicotine activates the sympathetic NS.
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18
Q

What are xenobiotics and where are they found?

A

Substances not normally found within the body.
- Plastics
- Heavy metals
- Herbicides
- Pesticides

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19
Q

How does dysbiosis contribute to cancer? (4)

A
  • It increases beta-glucuronidase
  • It increased leaky gut
  • Certain pathogenic strains (e.g. Bacteroides Fragilis) are linked with cancer risk via inflammation
  • Skin/oral/vaginal microbiome disturbance is linked with local cancer risk
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20
Q

What is beta-glucuronidase, what is its purpose and what are the consequences of low and high levels?

A
  • An enzyme
  • It plays a critical role in metabolic and detoxification processes within the human body
  • Low levels: poor detoxification of certain substances, impaired hormonal balance
  • High levels: Excessive breakdown of glucuronides causing cancer and inflammation.
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21
Q

How does leaky gut contribute to cancer?

A

Chronic inflammation

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22
Q

How does stress contribute to cancer? (4)

A
  • Increased DNA damage
  • Inflammation
  • Decreased immune surveillance
  • Decreased P53 tumour supressing gene
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23
Q

How does disrupted sleep contribute to cancer?

A

Decreased melatonin which is a powerful antioxidant

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24
Q

How does saturated fat contribute to cancer?

A

Intestinal inflammation and dysbiosis

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25
How does poor methylation contribute to cancer?
It causes oxidative damage to DNA
26
Which nutritional deficiencies contribute to cancer and how? (5)
- Vitamin B12: Impaired immune system. Disrupted DNA synthesis and cell growth - Folate: Needed for DNA replication and repair - Vitamin D: Needed for cell growth and differentiation. - Vitamin A: Correlated with increased incidence of breast, lung & skin cancer. - Selenium: Cofactor for glutathione peroxidase, an enzyme that protects cells from oxidative damage.
27
What is the general naturopathic approach to cancer (not supplements)
- CNM Naturopathic diet - Polyphenols - Optimise Omega 6:3 ratio - Avoid high heat cooking - Exercise - Ketogenic diet / - Fasting mimicking diet
28
What is the focus of the CNM naturopathic diet for cancer support? (9)
- Decrease refined carbohydrates - Avoid processed meat - Avoid dairy - Increase antioxidants - Sufficient quality protein - Increase fibre - Balance blood glucose - Optimise sleep - Reduce stress
29
What do polyphenols do in the body to support cancer? (4)
- Antioxidant - Support apoptosis - Inhibit angiogenesis - Support p53 gene (tumour suppressor via NF-kB & mTOR inhibition)
30
Name key polyphenols together with their food sources to support cancer treatment (6)
- Curcumin (turmeric) - EGCG (green tea) - Lycopene (cooked tomatoes) - Resveratrol (blueberries, raspberries) - Anthocyanins (blueberries, red grapes) - Quercetin (blueberries, onions)
31
What is the optimal Omega 6:3 ratio and what does Omega 3 do in the body to support cancer?
1:1 - 2:1 - Anti-inflammatory - Inhibits NF-kB - Generates resolvins & protectins
32
What does exercise do in the body to support cancer treatment? (5)
- Improves metabolic health - Reduces inflammation - Reduces obesity - Decreases insulin signalling - Increases oxygen intake
33
What is the nutrient ratio in the Ketogenic diet? What does it do in the body to support cancer treatment?
75% fat / 5% carb / 20% protein - Starves the tumour of glucose - Reduces insulin
34
How do you do a "fasting mimicking diet"? What does it do in the body to support cancer treatment? (7)
Plant based, low calorie "fasting days". - Reduces glucose - Reduces insulin - Reduces IGF-1 - Reduces Leptin - Increases Adiponectin - Increases AMPK - Increases autophagy
35
What is cancer cachexia and what causes it? What supplements help to prevent it (give doses)
Weight loss and muscle wasting caused by increased energy expenditure from excessive inflammatory cytokines - EPA 3g (range 180mg - 4.9g) - DHA 3g (range 120mg - 3.2g) - Carnitine - 3g
36
What is the optimal Vitamin D range in the blood for cancer support?
75 - 125nmol/L
37
What nutritional supplements are recommended to support cancer treatment? (Give dose)
- Vitamin D (optimise levels) - Medicinal mushrooms: Shitake, Turkey Tail, Reishi (6 - 10g) - Vitamin C (1-5g for prevention / 10g intravenous for treatment) - Proteolytic enzymes (per label) - Resveratrol (1,500 - 3,000mg) - Turmeric (1 - 2g) - Milk thistle (per label)
38
What does Vitamin D do in the body to support cancer treatment? (7)
- Anti-inflammatory - Immune modulatory - Promotes cell differentiation - Inhibits cancer proliferation - Anti-angiogenesis - Pro-apoptosis - Improves response to chemotherapy
39
What is the key constituent of medicinal mushrooms for cancer support? What do they do in the body to support cancer treatment? (6)
Triterpenes - Inhibit NF-kB - Support immune function - Anti-angiogenesis - Anti-proliferative - Pro-apoptosis - Improve chemotherapy outcomes
40
What does Vitamin C do in the body to support cancer treatment? (3)
- Improves immune function - Decreases oxidative stress - Can reverse genetic impact of environmental toxins
41
Name 3 proteolytic enzymes. What do proteolytic enzymes do in the body to support cancer treatment? (2)
Serrapeptase, papain, bromelain - Immunomodulatory - Break down tumour extracellular matrix
42
What does Resveratrol do in the body to support cancer treatment? (3)
- Anti-oxidant - Anti-inflammatory - Anti-tumour
43
What does Milk Thistle do in the body to support cancer treatment?
- Regenerates hepatocytes - Anti-proliferative
44
Which 3 nutritional supplements should you take care of in cancer patients and why?
- Folate - deficiency is a cancer risk but it can aid proliferation of cancer cells - Iron - Anaemia is common in cancer but it fuels tumour growth - Glutamine - It aids proliferation of cancer cells
45
What is the "if in doubt" answer to what any nutrient does to support cancer? (5)
- Improves immune function - Decreases oxidative stress - Anti-angiogenesis - Anti-proliferative - Pro-apoptosis
46
What 3 alternative modalities/therapies can be used to support cancer patients?
- Gerson therapy - Hyperthermia therapy - Oxygen therapy
47
Describe some of the key treatments in Gerson therapy (4)
- Organic, plant based - 13 raw juices daily (hourly) - Supplements: potassium, pancreatic enzymes, iodine, B3, B12 - Detox with coffee enemas, castor oil packs
48
How does Hyperthermia therapy help treat cancer?
- Tumours form heat shock proteins which are detected by the immune system
49
How can you apply oxygen therapy? (3) What is its core aim? What does it do in the body to support cancer treatment? (2)
- Hyperbaric chamber / ozone therapy / oxygenated water - Increases oxygen in body tissues - Enhances NK cells and immune system - Decreases tumour cell growth, pro-apoptosis
50
What are the risk factors for Breast Cancer?
All normal + Sex hormone imbalance caused by: - Exogenous oestrogen (HRT/OCP/Xenoestrogens) - Not having children - Obesity - Poor liver detox - Constipation - Dysbiosis Normal risk factors: - Genetic mutations - Hyperglycaemia (from refined carbohydrates) - Obesity & chronic excess calories - Chronic inflammation - High Omega 6:3 ratio - Low Vitamin D - Aspartame - Dairy Products - High temperature cooking - Alcohol - Smoking - Xenobiotics - Dysbiosis - Stress - Disrupted sleep - Nocebo effect - Saturated fat - Poor Methylation - Nutrient deficiencies
51
What are the 3 main oestrogen metabolites and their impact in cancer pathogenesis?
2-OH-E1 - weak oestrogen. Anti-cancer 4-OH-E1 - pro-cancer 16-OH-E1 - causes DNA damage
52
How do you support breast cancer patients? Give specific areas to support and list the normal cancer support diet / lifestyle / supplement advice
All normal + - Support hormone detoxification - Increase fibre - Iodine Normal support: - CNM Naturopathic diet - Polyphenols - Optimise Omega 6:3 ratio - Avoid high heat cooking - Exercise - Ketogenic diet / - Fasting mimicking diet Normal cancer supplements - Vitamin D (optimise levels) - Medicinal mushrooms: Shitake, Turkey Tail, Reishi (6 - 10g) - Vitamin C (1-5g for prevention / 10g intravenous for treatment) - Proteolytic enzymes (per label) - Resveratrol (1,500 - 3,000mg) - Turmeric (1 - 2g) - Milk thistle (per label)
53
How do you support detoxification in cancer patients? Name the areas to support and nutrients to help this.
1) Reduce exposure to xenobiotics 2) Support elimination - fibre to bind metabolised hormones 3) Support Phase 2 detox - methylation, sulphation, glucuronidation, glutathione conjugation - Folate - B12 - B6 - SAM-e - Choline - Betaine - Glutathione 4) Support Phase 1 detox - Support CYP1A1 to enhance 2-OH-E1 - Cruciferous vegetables for I-3-C - Berries - Celery - Turmeric - Resveratrol - Omega-3 - Flax seeds
54
What 2 methods can be used to diagnose breast cancer and what imaging type do they use?
Mammography - radiation X-ray Thermography - Infrared thermal imaging
55
What are specific risk factors for colorectal cancer? Explain why for each one (3)
- Dysbiosis and mucous membrane breakdown as this exposes the colonic epithelium to toxicity, inflammation and oxidative stress - Red/processed meat - n-nitroso compounds - Low fibre - fibre protects by increasing stool bulk to dilute toxins and increases SCFAs.
56
What nutritional supplements would you use to support a patient with colorectal cancer? (3) Give at least 2 mechanisms for each one.
- Quercetin (1-2g) - Anti-inflammatory: inhibits NF-kB, TNF-alpha, COX-2. - Antioxidant: ROS scavenger, induces glutathione - Anti-proliferative - Pro-apoptosis - Calcium: - Anti-proliferative - Pro-apoptosis Green Tea: - Anti-oxidant - Anti-proliferative - Pro-apoptosis
57
What should you take care to do when using supplements with a patient who is having chemotherapy?
Advise them to stop for 2-3 days before and after treatment unless a supplement is specifically determined as safe with chemotherapy.
58
How can you help a client having chemotherapy to reduce nausea? (3)
- Eat frequently (every 2 hours) - Use ginger in tea / cooking - Acupressure on pericardium 6 point
59
How can you help a client having chemotherapy to reduce diarrhoea? (2)
- Probiotics: Lactobacillus, Bifidobacterium, Saccharomyces - Slippery elm powder
60
What are the benefits of exercise for patients having chemotherapy? (6)
- Boost immune system - Boost metabolism - Boost neuroendocrine function - Boost epigenetic function - Reduce side effects including fatigue, nausea, vomiting - It's linked with increased survival rates
61
What nutritional supplements and other advice would you use to support a patient having radiotherapy? (5)
- Vitamin D: Reduce severity of side effects and osteoporosis - Probiotics: Protects against diarrhoea, enteritis and colitis - Deglycrrhizinated liquorice: Protects mucosa by increasing blood supply, increasing mucous production and increasing life-span of intestinal cells. - Calendula: Soothing topical application - Exercise: to reduce side effects, boost immune function etc.
62
What advice would you give to a patient having stem cell therapy? (3)
- Avoid infection - Increase protein - Increase polyphenols

CNM NUT 2 S2 - KZ (15 decks)

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