Naturopath and nutritionist John Stirling, ND, comments on the latest research into cancer.

Inflammation may play role in metastasis of prostate cancer

Many would assume that "mounting an immune response" or "having your body fight the cancer" is a good thing. Now, research at the University of California, San Diego (UCSD) School of Medicine strongly suggests that inflammation associated with the progression of tumours actually plays a key role in the metastasis of prostate cancer.

The research, appearing online in advance of publication in the journal Nature, identifies a mechanism which triggers metastasis. The findings by Michael Karin, PhD, professor of pharmacology in UCSD's Laboratory of Gene Regulation and Signal Transduction, and colleagues may help solve the puzzle of why it takes so long for cancer to metastasise, as well as what causes it to do so.

A major hypothesis in cancer research has been that whether the cancer metastasises or not is determined by genetic changes within the cancer cell itself. But this hypothesis didn't explain why metastases appear many years after the initial tumour.

Biopsies and inflammation

"Our findings suggest that promoting inflammation of the cancerous tissue, for instance, by performing prostate biopsies, may, ironically, hasten progression of metastasis." said Karin. "We have shown that proteins produced by inflammatory cells are the 'smoking gun' behind prostate cancer metastasis. The next step is to completely indict one of them."

One in six men will be diagnosed with prostate cancer, and one in 33 will die of metastatic disease. Early tumours confined to the prostate can be treated, but no effective treatments are available for metastatic disease, according to Steven Gonias, MD, PhD, professor and chair of the UCSD Department of Pathology.
"This study helps explain the paradox that, in certain types of malignancy, inflammation within a cancer may be counterproductive," said Gonias.

In research using mouse models and confirmed in human tissue, the scientists observed that a protein kinase called IkB kinasea (IKKa) turns down the expression of a single gene called Maspin, which has well-established anti-metastatic activity in breast and prostate cancers. They found that the production of Maspin is repressed by a series of events triggered by tumour inflammatory cells, with the result that prostate cancer cells spread.

Malignancies progress through stages. In early, non-metastatic tumours, a high level of Maspin is present, but it is turned off in late stages. Early tumours contain low amounts of active nuclear IKKa, whereas late-stage tumours contain the highest levels of active nuclear IKKa.

A case for anti-inflammatory?

This is interesting work and broadly fits with the view that Dr Josef Issels put forward some 20 years ago, namely that low-level inflammation acted as a focal point weakening the organism's resistance by stealth. A cancer would then able to capitalise on this weakness within tissue and given this foothold it was more able to spread.

Moreover, Issels contended that low-level inflammation was probably associated with most types of tumours rather than, as this research suggests, specifically with prostate cancer.

However, it is known that cyclooxygenase (Cox-2) activity is pronounced in prostatic tissue even in the earliest stages of its diagnosis and has been identified as a factor in precancerous changes in prostatic tissue. It is also present in benign diseases of the prostate, but is substantially lower in prostate tissue in healthy men. Cox-2 is a potent free radical generator and potentiates degenerative changes in tissue. This research I believe bolsters the arguments for the use of anti-inflammatory intervention in helping to either arrest the disease or at least slow its progress.

The dilemma is that conventional anti-inflammatory drugs generally tend to be immune-suppressive. This unfortunately in the long term defeats the objective and would actually encourage tumour growth and widespread proliferation of the tumour.

So these findings perhaps increases the argument for the use of high dose EPA, Flaxseed lignans and a number of other natural anti-inflammatory substances, as these agents not only help reduce inflammation naturally with very few side-effects, but they also tend to support the immune system rather than suppress it.

This data inadvertently helps shed some light on identifying why the Mediterranean diet seems to have an important protective role against prostate problems in men who consume weekly amounts of fish, fruits, vegetables, whole grains and olive oil. All of these foods are a good source of EPA, essential fats, vitamin C and other anti-oxidants, as well as providing a good source of lignans, and are known to be beneficial in modulating the immune system and controlling inflammation.

In summary, as prostate cancer is a leading cause of death in men and the disease seems to be affecting a growing number of younger men, every avenue of research should be approached with an open mind. This research contributes what I believe to be another piece of valuable information in helping us appreciate and understand the complexities of the cancer problem.

It further highlights the multi-factorial influences that are a prerequisite in the ultimate development of a tumour and how cancer is not a single disease, with a single cause, nor a disease with a single answer.

NUTRITIONAL PROTECTION
Against Prostate Cancer

JOHN STIRLING & SIMON MARTIN

“Having left BioCare and after having a long break, John Stirling is now focusing on writing a series of books on nutrition and disease prevention. A former colleague and student of cancer pioneer, immunologist Dr Josef Issels, John has specialised in advising practitioners wanting to use a nutritional approach in their practices, and the books will outline key protocols.

Reproduced with the kind permission of Today's Therapist