AntiCancer: Explore a New Way of Life

M. D. Anderson Cancer Center
Community Education Event Recording
Date: July 22, 2009
Duration: 0 / 1:31:04

Lorenzo Cohen, M.D.:

Hello, good evening. My name is Lorenzo Cohen. I'm Director of the Integrative Medicine Program here at M. D. Anderson. And I'm so pleased to see so many of you here for this evening's event.

Dr. Servan-Schreiber is a dedicated scientist and doctor, acclaimed author in cancer survivor. He's a clinical professor of psychiatry and co-founder for the Center for Integrative Medicine at the University of Pittsburgh Medical Center. He received his MD from Laval University in Canada, and then went on and did residency training in Western Psychiatric Institute and Clinic in Pittsburgh. He's also received a PhD in neuroscience from Carnegie Mellon University. He's a founding member of the organization Doctors without Borders, and I assume most of you are aware of the critical worth of that organization has done around the world. His book "AntiCancer: A New Way of Life" was inspired during his personal battle with brain cancer. When Dr. Servan-Schreiber was diagnosed with brain cancer, it changed his life. Confronting what medicine knows about illness, the little known workings of the body, and natural cancer fighting capabilities, and his own will to live, he found himself on a 15-year journey from disease and relapse into scientific exploration and finally to health. “AntiCancer” is a story of one doctor's inner and outer search for healing through discussion of the environment, lifestyle, and trauma. The core of his book is that cells lie dormant in all of us, and we all must care for that terrain in which they exit. The book has rightly received much attention. It has been translated into over 33 languages with over a million copies in print.

Recently when I was describing the Integrative Medicine Program to somebody, they said to me, "You know, you really should write a book about this." And I said, "Dr. Servan-Schreiber has already written that book." Dr. Servan-Schreiber's book is something we recommend to all of our patients to read. I recommend it to all of my family members to read and everyone I know because we will learn about cancer prevention and how to lead a healthy and fulfilling life.

Following the presentation tonight, you'll be able to buy copies of Dr. Servan-Schreiber's book outside and he will have some time to be able to sign them as well. I encourage you to purchase the book. If you don't purchase it tonight, purchase it at some point in time. And proceeds from the purchase of the book from M. D. Anderson go to M. D. Anderson Cancer Center, which is also a wonderful contribution. Join me in welcoming Dr. Dr. Servan-Schreiber.

David Servan-Schreiber, M.D., Ph.D.:

Thank you very much and thank you for such a warm welcome. And the opportunity to speak in Houston about--and at the M. D. Anderson Cancer Center, about my own theories about cancer, you know, this is quite an intimidating thing to do. Who am I to be coming to M. D. Anderson to tell them what I think about cancer. Thanks for being willing to listen and sharing this with me. This will be a series of interesting facts about how we can all protect ourselves from cancer, but it is also simply a story. This is how the story started.

I'm a physician and a scientist, and this is the last picture that was taken of me before that particular life, a life of success in academic medicine, of ambition, relentless arrogance turned around. Two weeks after this picture was taken, as a neuroscientist that was running experiments in brain imaging at the University of Pittsburgh and I, one evening one of the subjects did not come. We did not want to waste the precious scanner time so I got into the scanner myself. And my friend Jonathan with whom I was running the experiment was in the control room. And at some point, Jonathan talked, told me on the intercom there is something wrong, we're coming in. And he came into the scanner room, pulled me out of the machine, and put his hand on mine and said, "David, there's something in your brain and we can't do the experiment."

And that's how I learned that I had brain cancer. I was 31. And as a physician and a scientist, I thought this was not something that happened to physicians and scientists. We were naturally protected from such events. But lo and behold, I had not been. I went of course through conventional treatment. This was me a few weeks later. And that saved my life. However, a few years later, my tumor relapsed in spite of the fact that it had, you know, incredible good fortune, been detected so early. And I had conventional treatment again with more surgery, radiotherapy, and chemotherapy. And at that point, I realized that if I left it to conventional treatment alone, I would have conventional outcome. And the conventional outcome for my disease was not promising.

So one of the things that supported me the most are the story of another scientist with cancer that I want to tell you about because I think it is so important in our understanding of how to proceed with that condition if we're affected by it. This is the story of Stephen Jay Gould. Stephen Jay Gould was a zoologist and biologist, professor at Harvard University, and at the age 42, he learned that he had the mesothelioma of the abdomen. The oncologists in the room know that the median survival for the mesothelioma of the abdomen is 8 months. It's a very severe condition, usually due to exposure to asbestos. Gould was stunned by the news of his expected survival. And it took him a little while to recover his ability to think about it. But when he started thinking about it as a major biologist, he thought, "Okay, what is a survival curve like and what is a median survival?" And this is what the curve looks like where a median survival of 8 months means that half of the people will live less than 8 months, but half of the people will live for longer than 8 months. And then Gould focused on the fact that being 42, which is reasonably young, nonsmoker, non-alcohol drinker, in recently good shape aside from having a lethal cancer, his chances were that he would be in the right half of that curve and he was right. Then he reasoned that every single survival curve it seemed in his life had this particular characteristic of having a long tail end, long tail. And that means that in this region of the curve, there is a small number of people, it is a small number, but there is always small number of people who live well beyond the median. And so he set his goal as one of being part of that little group. And Stephen Jay Gould lived another 20 years. He died of a totally different disease after having had one of the most productive and remarkable scientific careers of the 20th century.

So it is possible and that became my goal as well. But I realize that if I wanted to make it to the tail end of that survival curve, I was gonna have to find out everything I could do about how I could help myself in addition to the conventional treatments. And so I did what I normally did as a physician and a scientist. When I wanted to learn something, I hit the books and the journals, and I tried to find every bit of scientific information that would shed more light on what I could do to help myself. And the first thing I learned was a rather depressing lesson at first but with a powerful glimmer of hope in it. I learned that unbeknownst to me, we all carry cancer cells after a certain age. All of us carry cancer cells. I also learned that we're all exposed to the cancer promoting factors, carcinogens or factors that help with an existing cancer grow faster. I learned that 1 of in 4 us will die of cancer. It's a pre-depressive statistics. But the glimmer of hope, highly important glimmer, is that 3 out of 4 of us have cancer cells, are exposed to carcinogens, yet will not die of cancer. What does that mean? It means that for 3 out of 4 of us, a large majority, 75 percent, there are natural defenses in the body that are able to prevent the cells from becoming a lethal disease. And so my goal became try to understand what happened to me that my defenses didn't do the job, and what I could do to strengthen the defenses so that they would start to doing better job.

And this is what I learned. Things, facts that are all over the scientific literature that I had not seen put together before that which when you bring them together, it give a quite clear picture of what is going on and how we may be able to help ourselves with respect to those condition. First, I learned that we live in the middle of what epidemiologists call a cancer epidemic. Dr. Cohen just reminded you number 1 disease cause of death as of 2010, 1 in 2 men, 1 in 3 women will be affected by this. If this is not an epidemic, I don't know what it is. And I learned that this epidemic started in 1940. This is the breast cancer epidemic that you see in here. It starts around World War 2, and the rates keep going up. As a physician working at a hospital all of my career, I had been told by my cancer or my oncologist colleagues that the reason the numbers are going up is because the population is getting older, so mathematically, there's more cancer, and also because we detect cancer much more systematically, so the numbers go up. And that is true of course. But I learned that this explains only about 30 to 40 percent of the increase in cancer rates. In fact, this is well demonstrated by another very sad reality which is that the cancer rates in children as published in the Lancet in 2005. The cancer rates in children have been going up 1 to 1.5 percent per year for the last 40 years or so. And children are not older and we do not screen for cancer in children. So there--this is obviously not the right explanation. Something is happening to us that is making cancer rates skyrocket.

Then I found out something else very striking, which is happening only to us, meaning us in western northern hemisphere societies. These are World Health Organization maps of cancer epidemiologists going all around the world with the same screening methods that we use in western countries, looking at populations of the same age for cancers. This is the breast cancer map but you can do the same thing with colon or prostate, and these red areas are the areas of high rates of breast cancer. You see that it affects primarily western, northern Europe and northern--North America, Canada and the United States. When breast cancer affects the southern hemisphere, it is located in areas of the world that have adopted our lifestyle, Australia and New Zealand or in South America, Chile and Argentina. In Africa, the only country affected is South Africa, which has adopted our lifestyle. And in the Middle East, the only country affected and you can't see on this map is Israel. In some regions of rural China, when the investigators of the World Health Organization were looking for breast cancer, they could not find any case of breast cancer. So this gives us pause, think about the number of people around you, the number of women around you know with breast cancer. I cannot imagine that there's a single person in this room who is not affected by this condition and their immediate family or friends or coworkers. We now are seeing cases of women who have breast cancer in their 30s, in their 20s. Not only that, but we see women who die of breast cancer in their 30s. So this is not a matter of just detecting it earlier. There are women who die of breast cancer in their 30s. This is something that was unheard of before 1940. When you speak to older physicians, they say that when a woman has breast cancer before 50, the whole hospital would come and see 'cause it was such a rare case. How many women do you know less than 50 with breast cancer today? So the question immediately arose to these World Health Organization epidemiologists, is there something specific about Chinese women that they're protected against breast cancer that we can't find it? Is it that Chinese women have very small breasts compared to others or is it perhaps that they have genetic makeup that protects them from this particular disease? And unfortunately for Chinese women, if this is what you see, if you look at Chinese women in Shanghai, different age groups, this is the rates of breast cancer in Shanghai. If you look at them in San Francisco after 1 or 2 generations, they have the same rates of breast cancer than American women. So it is not about being Chinese. It is about the lifestyle of Chinese women in rural China, and the lifestyle of we, Americans, in America.

So that immediately raises the question, if the rates of cancer has been shooting up since 1940, Second World War, and this has happened particularly in western, northern societies or those that have adopted the lifestyle of northern, western societies, then what happened in those societies since 1945? And in fact, it's possible to find in the scientific literature the facts that explain that transformation. Number 1, sugar consumption. I'll go back to this in a minute. But sugar, it turns out, is the principle food that cancer cells feed on. It was a Nobel laureate who received the Nobel Prize in the 1930s for discovering that cancer cells are obligatory sugar feeders. They cannot feed on other sources of food like proteins or lipids. They have to feed on sugar. In fact we used that property when we do a PET scan to detect the presence of cancer in the body. We inject radioactive sugar, glucose, in the body and look at where it accumulates. And our sugar consumption has exploded during the 20th century. I'll get back to that.

The second thing that changed and particularly after World War 2, the second thing that changed after World War 2 is the different kind of fats in our food. We invented trans fats, for example, which are industrial kinds of fats that are used instead of butter because they do not go rancid and it allows industrial food to stay on shelves in supermarkets for 2 years without going bad. It allows French fries to be fried in the same oil again and again and again without the oil turning bad. However, our bodies never were exposed to trans fats before World War 2 and they don't know what they are and they don't react well to them. A recent report to the Dutch Ministry of Health, 2 reports were turned in, in the same 3 months period, in the Dutch Ministry of Health, one showing the number of deaths from motor vehicular accidents, which was about 8,000, and another one showing the number of deaths attributable to the consumption of trans fats, which was about 12,000. So it means that there are more people dying of trans fats consumption every year in the Netherlands than of motor vehicle accidents. And when you think of all the efforts we're putting into controlling motor vehicle accidents, all for people to just go through the drive-through at McDonald and load up on the trans fats, it seems like there's something is not right in how we're proceeding about protecting our people.

The other thing that changed is the balance between essential fatty acids, the so-called omega-3 essential fatty acids that are good for you and I'll explain that in detail, and the omega-6 fatty acids that are actually pro-inflammatory and help the growth of cancer cells. And this changed dramatically. Since after World War 2, animals stopped feeding on grass and have been fed purely with corn and soy that has eliminated omega-3s from the diet of animals and therefore from our own. Chemical exposure, DDT was invented in the 1930s. There were no chemical pesticides in our environment before World War 2. Today, we're exposed to an enormous amount of chemicals that have been categorized as many of them have carcinogens or can promote cancer growth. See the entirety it turns out that physical exercise we now know and I'll get back to that briefly is one of the main factors to help protect our body from the effect of carcinogens.

So when you exercise, you eliminate carcinogens more easily, your immune system is strengthened against the progression of cancer, and you reduce the body's sugar load and the accumulation of estrogens and body fat and so on. So, physical activity is a fantastic protection against the possibility of developing cancer. Now I want to do a little survey with the room here to, if you will, engage me in this little game, to give you a sense of how much our relationship to physical activity has changed since World War 2. How many of you have grandparents who walked more than 15 minutes to go to school? Raise your hand and keep your hand up. Keep your hand, your grandparents walked more than 15 minutes, keep your hand up. I see some of you don't wanna do any exercise. I told you exercise is good for you [laughter]. Keep your hand up. Now look around you so you get a sense in the room. Look around, this is a fall, okay? Grandparents walked more than 15 minutes to go to school. Okay, you can put your hand down. Now, how many of you have children or grandchildren who do walk more than 15 minutes to go to school, and there should be a few and in Houston not many. Okay, there's a few. There's usually about 2 to 3 percent. Okay, now you can look around and that gives you a sense of how much our relationship to physical activity has been transformed in the last 50 or 60 years. Radical.

Now the last thing that has profoundly changed is the nature of our social network and social support. Every social study shows that the intimacy of a social network is the number 1 protector against the deterioration of health. It may seem strange at first, but it is as damaging to your health to have a poor social support system as to be smoking. It's exactly the same damage. Now it turns out that we, Americans, are now moving on average every 5 years. What does that mean when we move every 5 years? We lose connection with our neighbors, by definition, but with many of our friends, and in general, we move further away--with every move, we move further away from our aunts and uncles and our parents and our brothers and sisters. And originally, we do this on purpose. This is our [laughter] you know ability to move on with life. But as it turns out, when we get to times of our life, we're facing very severe stresses or illness that social network is not there for us to help us withstand the blows of life. And this has changed dramatically since World War 2.

So now, let me show you a little bit more specifics about this. This is the consumption--the production of refined sugar for human consumption in the US. In the 1800s, the average human consumption of refined white sugar was 12 pounds per person and per year, okay. In 2000, it's in kilograms, but this is 154 pounds. Now, this is fascinating 'cause most of you cannot even imagine eating 154 pounds of refined sugar, right? And you see--you can't see the big bags of sugars coming to your house. So, but you are. We are. 154 pounds on average. Some people eat a lot more than that. Now, I don't eat any so somebody must be eating you know, [laughter] twice the 154, right? That's 308. So that's just an average. So where does that sugar come from? Well, it turns out that industrial food has found a remarkable way of conveying sugar into our bodies without us noticing. For example, how many little packets of white sugar would you put in your coffee or tea before feeling guilty and thinking that, "I'm overdoing it." How many? [Chuckles] No, how many do you, you know, if you were to put sugar in your coffee, how many packets would you put in before feeling like you're--it's gonna be too sweet? 3, 3 is the usual answer. Okay. Now, how many such little packets of sugar are there in 1 can of coke? 1. No, 12. But 13 is not far. 12, you can count it, you know. 1 packet of sugar is 3 grams. Look at the can of coke. Look at, you know, carbohydrates, number of grams you'll see 3, 6. So it's 12 packets of sugar in 1 can of coke. So Coca Cola is, and I don't wanna, you know, stigmatize Coca Cola more than anything else, but it is an incredible vehicle for making people drink an amazing amount of sugar without noticing. They created that. And the amazing thing is you're still hungry after you had the coke, you know. It's not gonna make you cut down on the ice cream, right? In fact, now, they have the, you know, a lot of people put ice cream in Coca Cola, so you [laughter] can be sure to get the full dose.

These here are omega-3, your omega-3 essential fatty acids and omega-6 essential fatty acids. They're called essential because they are part of every single cell membrane in the body. At the same time, they--the body does not know how to manufacture them. Now think about that strange situation. Every single cell membrane is made of these but we can't make them. That means they come from 1 source, 1 source only which is your plate. If they're in your plate, they're in your cells. If they're not in your plate, they're not in your cells. It turns out that omega-3s and omega-6s have very different properties. Do you see that here? The flexibility of the omega-3 fatty acid that I like to say is so cute that you wanna pat it on the nose. [Laughter] It's very different from the omega-6. Not only that, but once in the body, these omega-3s and omega-6s get metabolized into very biologically active molecules that have very different properties.

Let me show you the next slide. In the body, this is the source of omega-6 fatty acids vegetable oils like the, you know, vegetable, the salad dressing you get in most restaurants made of corn oil, sunflower oil, trans fats, and meat, and dairy products that are not organic from animals that have not been fed with grass which is now the case. These have a lot of omega-6 fatty acids and these fatty acids get metabolized in the body into prostaglandins and other molecules that are responsible for inflammation, coagulation, and stimulation of cell growth. Pay a lot of attention to that, stimulation of cell growth. Omega-3 fatty acids that come from flaxseed oil, walnut oil, especially from cold-water fatty fish, organic meat, and organic dairy or organic eggs from animals that fed on grass, these actually are metabolized in the body into molecules that regulate inflammation, reduce coagulation, and regulates cell growth. Now when you have as many omega-6s and 3s in the body, everything is fine, and the body can use cell growth when it needs to, it can stop cell growth when it needs to. It can use inflammation to respond to a wound. It can stop inflammation after it has responded to a wound.

However, something happened in our society that after starting as of World War 2, we started producing soy oil which is primarily omega-6 for human consumption in massive amounts. Every single industrial processed food you're eating has these vegetable oils. Look at the ingredient list and you'll see them. Massive amounts, an explosion. They're part of every processed food. Not only that, but we also did something that in the history of human kind has never happened. We changed the way we feed the animals that feed us. This is the modern American farm. And I like to say that I was raised on a farm in Normandy in part. I was mostly raised in Paris but my grandfather and then my grandmother were mayor of that village in Normandy for 45 consecutive years so I spent a lot of time on the farm in that village. It did not look like this at all. You know, there were about 12 cows on that farm and at lot of land. And they ate grass all day long. Now why is that important? Because grass is actually extremely rich in omega 3 fatty acids. And when the cows eat grass, there are omega-3 fatty acids in their milk, and the cheese and butter we derive from their milk and the cream and in their flesh and the meat we eat that comes from cows. The same terms ought to be true of hens. Now here this new grass whatsoever. They get fed only on corn and soy. And it turns out the corn and soy have almost no omega-3 fatty acids. So this is what happens to the content of cow meat in that industrial feedlot. When the calf is just separated from its mother after nursing, it has sucked in all of the omega-3s it could find in its mother who doesn't have much but there is a little bit. And the calf sucks it in, so in the calf's flesh, you find about 3 percent of the fat being omega-3 fatty acids, which is almost normal. Then this is the feedlot experience after 196 days, the time when the calf gets taken to slaughterhouse to become human food, the omega-3s have completely disappeared. So in the human food, they're gone. I was able to find studies looking at the ratio of omega-6s to omega-3 fatty acids in a variety of common human animal foods. This is the ratio in butter in 1960 where there was, you know, about twice as much omega 6s than 3s which is not bad. Butter was actually almost a health food until 1960. And this is the--and this is the ratio in 2000, it's 6 times more omega-6s than 3. Here in eggs, the most striking of all, my grandmother on that farm forced us kids to eat these eggs because she said they were indispensable to the development of our brains. I have no idea how she knew that. It was discovered 30 years later that omega-3s are absolutely indispensable to the development of children's brains. And the eggs on my farm were full of omega-3 fatty acids, of DHA, the long-chain animal omega-3 fatty acid. The eggs we're feeding our children today if you buy them in the regular supermarket and they doesn't say omega-3 eggs, they have 20 times more omega-6s than omega-3s.

So you're feeding your children pro-inflammatory cell growth stimulating foods and or cells. This is the history of humankind and the ratio of fats. You see 10,000 years ago was when we settled as an agricultural society, and our genes have not changed one iota since then. Our genes developed in the complex of as many omega-6s almost as many omega-6s and omega-3s in our diet. This has somewhat happened after World War 2, and this is where we are today. I--you know, I'd like to say that when--if we operate a lawnmower, we put the right amount of oil and gas, right, so that the engine works properly. Well, this is the amount of oil and gas we're meant to work with, and this is what we're putting in. Something has gone--is gonna go seriously array with the engine than it has.

This is the economist [laughter] rendering of what is not going well with the engine. Is this a familiar picture? As I told you, omega-6s stimulate cell growth, right? And the only 2 things that can grow in an adult body is fat and cancer, which is no surprise that fat--obesity is one of the leading risk factors for cancer. And let me now show you what has--what is happening to us as a society in terms of obesity. These are maps drawn by the Center for Disease Control, and this is the map of obesity in the United States. I'm talking about real obesity like the picture we've just saw, people with the BMI for those of you who are medically inclined, a body mass index above 30. This is morbid disabling obesity, okay? This is the map in the US in 1985 where the areas in light gray should be blue but it's not coming out right. The light gray is less than 10 percent. These areas are 10 to 15 percent, okay? I arrived in Pittsburgh in 1985. Pittsburgh is right here. And the people looked perfectly normal. They looked like the people in Europe or anywhere else. Now, this is what happened to us as depicted by the CDC. 1986, 1987, 1988, 1989, 1990, 1991, 1992, 1993, 1994, 1995, 1996, 1997, the first states with more than 20 percent, 1998, 1999, 2000, 2001, the first states with more than 25 percent, 2002, 2003, 2004, 2005, states with more than 30 percent, 2006, 2007. His is an epidemic. And remember, obesity is one of the leading risk factors for cancer. So of course it doesn't--you don't get cancer as soon as you become obese. It takes--there's a luck time. It takes several years, perhaps 10, which tells you that M. D. Anderson is gonna be in business for a while. There's no concern about that. Now, this is what--this is data that is not often used in how we treat cancer patients. This is the impact of omega-6 fatty acids on the risk of advanced breast cancer in the perfectly--the population of 35,000 women, perfectly normal at baseline, followed for several years, and they were divided among those eating very little omega-6s, more, moderately more, and much more. And you see that the risk of developing breast cancer is linear. It increases those response factors with the amount of omega-6s in the diet, and it gets to 2.5 the risk of breast cancer.

To put this in perspective, the risk of breast cancer associated with using hormone replacement therapy, which all of you have heard about as a bad thing to do if you don't want to get breast cancer, is roughly 1.4 to 1.8. This is 2.5. It's much more of a concern than hormone replacement therapy. Now the first time in the history of breast cancer in this country that the rates have gone down is when as of 2003 it was decided to stop giving women systematically after menopause hormone replacement therapy. When that was done, these rates of breast cancer started to go down. Same thing for colon cancer. You see here the risk of developing colon cancer as a function of the amount of fish, fatty fish people eat. This is a European study of almost 500,000 people published in Journal of National Cancer Institute. And you see that for those who ate a 100 grams of fatty fish per day on average, that is a fair amount of fatty fish to eat per day, but for those of the--those who did that, there's a 50 percent reduction in the risk of developing colon cancer. Well, I don't know of any other intervention that can be so powerful to reduce the risk of developing colon cancer. Chemical contamination. I told you this was a new phenomenon since 1940. Here's a paper published in Science which documented the explosion of synthetic chemicals to which humans are exposed since 1940.

Now it's not just humans. Here's one of 2 mammals on the planet that is the most highly loaded with synthetic chemicals that are contributing to development of cancer. It quite stunning why with the polar bear being exposed to these, it doesn't live next to any dumpsters or industrial area. But what happens is many of these chemicals are volatile. They're called organic volatile compounds. They escape into the atmosphere of warm areas. They then circulate around the planet. And when they get to cold areas, they precipitate full to the bottom of oceans. At the bottom of the oceans, they get captured by plankton. And plankton has a fair amount of contaminant, but it doesn't live very long, so it doesn't have time to accumulate them. Yet fish lives longer so they accumulate more of these contaminants. Seals live longer than fish and eat the fish, so they have a lot more of the contaminants. And who sits on top of the food chain? The polar bear eats the seals, so it gets all of the contaminants to the point where some of these are being estrogen-like. They interfere with the ability of the polar bear to have sperm, and therefore many of the males are now sterile. And this is the number one reason where they are at risk for extinction.

What is the other mammal on the planet sitting on top of this food chain? We, guys. This is a European study. 39 members of the European parliament, 14 ministers of the environment study done by the World Wildlife Fund to show the world that it was not just about polar bears. 13 products present in all of these people. So it's not just about being a worker in Estonia, you know, this is ministers of the environment in Europe. In America, the CDC study, 148 different toxic chemicals in the blood and urine of Americans of all ages, and not only that, but you know I told you--the longer you live the more likely you are to accumulate these of course. And the worrisome fact is that today, the grandparents and grandchildren have the same amount. Meaning that the increase in the exposure is such the children have as much in the short span they've spent on their planet, they've accumulated as much as the grandparents who live because they have the chance of living a good part of their life before World War 2. This is how we spread these. This is just for pesticides. Atrazine, one of the most popular pesticides in this country. You see the map of Atrazine use, you know, Texas is not protected. The map--of course this is the area, you know, the Corn Belt is the area of the most Atrazine use. Atrazine, one of the most successful pesticides is such an endocrine disruptor estrogen-like compound that it changes the sex of frogs in the rivers, and so much so that in the Potomac River in the Maryland, 80 percent of the male smallmouth bass now carry eggs. Exposed farm workers have higher cancer risks because of Atrazine especially women where the risk of breast cancer from exposure to Atrazine can go up to 7 or 9 times the risk of a normal population. And the worse is that their children have a higher risk even though they're not in the fields at the time when this is being spread. It's just from the residues remaining on their parent's clothing that--or their shoes when they enter the house, that exposes the children and the risk of leukemia is much higher than in the general population.

In fact, this is not the only source of exposure to pesticides in our children. This is a University of Seattle's study looking at 42 children ages 2 to 5. And it looks at the residues of pesticides in their urine because the pesticide industry is always saying, "Well, these substances are eliminated by the human body, it can't hurt. You know, they get into--they are filtered by the kidney and they get eliminated in the urine, so what's the problem? They don't accumulate." That is true. But here is the problem. If we--these children are eating conventional food and every single day you find these pesticide residues in their urine, so sure they don't accumulate but they're exposed every day. This is when they eat 70 percent of their diet is organic, you can see that this disappear. So it's possible they have diet that doesn't include those contaminants. This is when they go back to the conventional diet and that's the residues come right back. A few things about household products. It's not just about the pesticides. It's about things we do every single day in our homes. Like you, I dried clean my shirt and my suit. It turns out that dry cleaning uses perchloroethylene which is the well-characterized carcinogens. People who work in dry cleaning shops have much higher rates of cancer than others. People who live above a dry cleaning shops have much higher rates of cancer than others because these are volatile compounds. Now, what do you do when you dry clean your suit or your dress, you do probably like me. We carefully keep it under the plastic sheets, that sheeting, right, and put it in the closet and its plastic bag so that when we get to wear it, we make sure that we maintain the maximum concentration of perchloroethylene on the surface, we can inhale it fully. It turns out there's an easy way to get rid of that. Just air out your dry cleaned garments for 2 hours or use a dry cleaner that doesn't use those substances. It's easier to find it in San Francisco than in Houston or Pittsburg or Paris, but this will come. Obviously if we don't want pesticides in our food, don't spray them in the house. Women who spray insecticides and pesticides in the house have higher risk of having children with leukemia 7 or 8 years later. And it might--if you have cancer, it might contribute to resistance to treatment.

A word about the perfumes. Perfumes often contain phthalates and parabens. These are known to contribute to cancer growth. And recently, a study was done of which perfume contained higher amounts. And it was interesting that one of the leading ones was a new perfume from a few years ago from Dior, a recent perfume house and fashion designer, and it's perfume is called Poison. [Laughter] So, remember that. It will help you think twice when you buy a perfume at the airport next time.

The BPA of heated plastics. All hard plastics, polycarbonate plastics has a substance called BPA which is also an endocrine disruptor, acts like estrogen, has recently been found to prevent chemotherapy from working in--on human breast cancer cells in a Petri dish. It hasn't been tested in human beings so we don't know that in a Petri dish, it prevents chemotherapy from working on human breast cancer cells. It turns out that every time you heat liquids in the hard plastic, as you often do in the microwave oven, it releases BPA. Unfortunately, many of the canned foods that we eat has a plastic sheet inside to protect it from getting the taste, the metallic taste of the can. But they heat those cans to 110 Celsius in order to sterilize them which release BPA. The number one source of exposure of humans to BPA is canned foods. So eat food canned in a glass jars if possible or frozen food, but try to avoid cans that have plastic lining which is most of them unfortunately.

A word about aluminum. This is a question women asked often, is there a problem with antiperspirant with aluminum. Aluminum is an irritant which can trigger inflammation locally. And indeed what most women do is they shave their armpits under the shower then they dry off, and when they're dry, they apply the antiperspirant. Now when they shave, they created little leaks in their skin which allows the aluminum to be picked up the lymphatic system and brought to the breast gland where it might produce inflammation and perhaps contributes to the growth of an existing cancer. We don't think it can cause cancer, but it might contribute to the growth of an existing cancer. Now this is still a hypothesis and it is not proven. However, there's this very curious study from England I want to show you where they looked at women who applied antiperspirant and shaved their armpits, and they happen to have breast cancer at a much earlier age than women who shave but didn't use antiperspirant. Women who use antiperspirant but didn't shave and women who didn't use antiperspirant, didn't shave, didn't have sex very often, they live longer.

So now, we've talked about all the bad news. Let me talk a little bit about the things that we can do to try to control that situation a little bit. The first very good news, often understated, is this. It is the fact that within our bodies we all have cancer cells as you see here, but we also have the powerful set of white blood cells as part of our immune system that constantly detect and destroy. This is in the human body what you're seeing, detect and destroy cancer cells. Here is another one to be detected and destroy. This is happening constantly. Our body lives in equilibrium with cancer. Cancer fabricates new cells, body identify, detects, destroys. This is happening all the time. This is our--one of our natural defenses against cancer. And in fact, there is a recent paper in Nature that was emphasizing that our adaptive immune system constantly maintains occult cancer. Occult is the key word here, meaning little micro tumors that nobody detects because they are not a problem. And the immune system maintains this occult cancer in an equilibrium state. And so it is when we interfere with our immune, with our natural defense's ability to do this job, that cancer gets a chance to grow on us. I wanna show you that this concept of natural defenses is not pie in the sky. This is a study published in 2008 in the very respected PLoS Medicine of over 10,000 people. They've looked at simple 4 simple health behaviors that they either did or didn't do. This is the survival curves of over 14 years. You see here people who didn't do any health behavior and the survival curve is pretty dismal. These are the people who did 1, 2, 3, and 4. These consisted of not smoking, not drinking more than 2 glasses of wine per day, eating 5 fruits or vegetables per day, and doing 30 minutes of exercise 6 times a week. Exercise could be walking. And if you work at M. D. Anderson and you don't take the golf cart, you know, [laughter] it's you're doing your 30 minutes, no problem. A huge survival advantage. It was not just for cardiovascular disease, the benefit was almost as big in terms of protecting against cancer death than it was in terms of protecting against cardiovascular death. And where it gets really interesting is that the researchers conclude that this is not just about living longer. Now, who wants to be--to live longer 'cause it gonna be miserable. They concluded that these people here, 12 to 14 years, had a biology that was 14 years younger, that means 14 years younger in terms of concentration, in terms of memory, in terms of energy to be with your partner, with your children or your grandchildren, in terms of your ability to sustain sensual enthusiasm for your partner 14 years younger from 4 simple behaviors. Now, this was from people who weren't sick in the beginning of the treat--of the study.

But it turns out this works from cancer patients as well. This is a stunning study that was published in 2008 in Cancer that looked at women who had breast cancer that had already spread to their lymph node. This wasn't the little tiny breast cancer that you just get rid of with surgery and, you know, and then everything is gonna be fine. It had already spread to their lymph nodes. They all received conventional treatment of excellent quality at Ohio State University, and then they were randomized in 2 groups. One was just followed with more additional treatment with just, you know, you know what they say--many of you imagine here have had cancer and like me, at the end of your treatment you say, "Well, doc, what can I do now so that it doesn't come back?" "Well, we're gonna follow your every 3 months and if it comes back, we'll get it early." Right?

"That's what I can do to help myself not get cancer again?" Well, this is what these women were told and this is their survival curve. The other group was randomized to an intervention where they learned in essence what I try to put in my book. They learned how to eat differently. They learned to include physical activity in their life more regularly. They learned to manage stress, and they got some social support from being in the group. These lasted a year. They met weekly for 2 months and then once a month after that for a year. And then they were left to their own devices. 11 years later, this is the difference in the survival curve between the 2 groups. A 68 percent reduction in the mortality in the women who participated in those lifestyle interventions. 68 percent, this is a stunning number. There's not a single drug, not one molecular targeted therapy, not one gene therapy intervention, nothing that can reduce mortality by 68 percent over 11 years.

Now, I wanna show you something really important. If you've had this conversation with your oncologist and you found them to be a little dense, I want to show you why you can--you can forgive them because this is another research in 2007, very important. Women with breast cancer following treatment and the--here's the survival curve of the women who don't do anything to take care of themselves, this gray line here, okay. Here's the survival curve of women who pay attention to eating 5 fruits or vegetables per day, this is not much, but at least they do that. Now, what do you see? You see a little benefit early on for the first three years. It might seem like they don't die nearly as much. But in the end, there's no difference. And most oncologists, this is what they say, they're saying, "No, it doesn't make much difference if my patients change what they eat, so why bother them with that?" You know they've had enough problems. They've had chemo. They've had bugged them, you know. The oncologist's job is hard because patients come to see them feeling reasonably good and it's the oncologists who tell them, "You're definitely sick." And then he or she makes them sicker, right, with the treatments and so it's a tough job to have. We have to give them back. And they don't want to burden you in addition by saying, "And I want you to stop the ice cream," alright? And you're gonna eat broccoli now [laughter]. They don't wanna do that. So, and this is what they've seen in the literature that many studies that have looked at doesn't make a difference to eating 5 fruits or vegetables, not that much. Does it make a difference to exercise or physical activity and most oncologists say, "Well, not really." Well, but for a few years, it does, right? But after 6 to 7 years, no difference in the survival curves. So the oncologists were not convinced.

Now, this is probably the most important slide of the whole talk. Look what happens when you do both. You do physical activity and you eat 5 fruits and vegetables. Something magical happens. This is way more than the benefits you've see from the chemotherapy intervention. The body stimulated to generate health. But it takes more than one single intervention to do that. It takes a concentrated multi-approach of at least 2 things. Now imagine you did all the rest on top. What does survival curve might be? This is just 2. Furthermore, we now have studies showing, oh, you can't believe you see anything here, you just have to go on trust. As a scientist, I hate to, you know, call up on you to go on trust but the projector is not cooperating. This is a gene--a genetic study that looks at gene activity. Each line here is a different gene. It looks at gene activity in people before they engages our men with prostate cancer, before they engage in the program of lifestyle change, eating differently, more activity, better stress management. And after, and what you see is a completely different map of gene activity. So the genes--the genes start to talk a different language, way deep inside the depth of the cells. The genes talk a different language if you participate in those lifestyle interventions. You're stimulating something all the way to the core of your cells that turns out to protect from cancer. Food, something about food we forget. You know when my oncologist told me, "Eat whatever you want, it won't make a difference", this is what they forget.

This is in Nature, okay. Now they don't read Nature, they can't read everything, okay. This is in Nature. It shows that every food is obviously made of chemicals just like everything else. These just happened to be natural chemicals, but their chemicals just like a drug is a chemical. And this is a paper in Nature that does the inventory of the chemicals that had been identified in foods with no well-characterized anticancer properties. A lot of this work has been done here at M. D. Anderson by some other leading biological scientists. One of whom has identified curcumin, the agent that's part of turmeric, you know, the yellow spice turmeric of curry? It turns out to be a profoundly active anticancer agent. It is the most potent natural anti-inflammatory substance that we know. But that's not to just of curcumin. The ginger olive ginger, the epigallocatechin-3-gallate of green tea, you need to learn how to say this very quickly if you wanted to work for you. The genistein of soybeans, the lycopene of tomato, the sulforaphane of the whole cabbage family of broccoli, of cauliflower, of brussels sprouts, the diallyl sulfide, the magical diallyl sulfide of garlic, onions and leeks that prevents the growth of new blood vessels that cancer needs to develop, and activates the immune system. This was called the Russian antibiotic during World War II 'cause they didn't have penicillin, so they treated all of their infections with garlic and they had reasonably good results as well. So as good, and I don't--if you have pneumonia, take antibiotics [laughter] don't take garlic. But it does have potent immune stimulating properties that can participate.

So foods have molecules, of course they do, that can have potent biological actions. In fact, the World Cancer Research Fund published a report in 2007 after reviewing 7,000 studies with 21 international experts concluding that most cases of cancer could be prevented simply with nutrition and physical activity because foods have such important impact, a few words about the typical anticancer plate. Now, this is the scary bit for many people because this is my rendition of the proper anticancer plate and it does not look like Texas ribs. [Laughter] You know, it is not your average Texan meal. In fact, the key concept here, think about the--now what is the national American dish outside of [inaudible]?

Audience: Hamburger.

Servan-Schreiber: Hamburger and French fries, right? Okay. In France, it is steak and French fries. And I was, you know, we're not much better, steak and French fries. So hamburger and French fries, think about that for a second. Red meat, the number one food associated with risk of cancer. Red meat contains primarily omega 6 fatty acids today because of the way we feed cows. Meat has not a single chemical in it that can help slow down cancer growth. This is what we make the core of our national dish. Then, you know, to make sure we don't fail, we add French fries. Now French fries is a great choice because potatoes are the only vegetables that have no anticancer property [laughter] whatsoever, and that increase blood sugar. It's a sugar. It increase--it's a high glycemic index food. It increases blood sugar and insulin that promote cancer growth. So we pick that as our national vegetable then we won't--you know, we didn't wanna fail so we dipped that national vegetable in trans fats, right? Or omega-6 oils, then we fry the oil because then it becomes oxidating. So when it uses up any antioxidant, we may have in our body from, you know, the little number of vegetables we eat, and we make that our national dish.

Now what I love about Americans, and I am American, but what I love about us is we can always improve on other people's performance. So, you know, in fact what we did is took the French national dish but we did better because we added a white bread bun around it, right? [Laughter] That suits up the glycemic index even more, and then what else did we do? What do we put on the meat between the bun and the meat? Ketchup, ketchup, an incredible load of sugar, we beat everyone. [Laughter] And that's our national dish. Now, look at this plate, the opposite of the American national dish. It looks like a Vietnamese national dish, but we know what we did to these people and now we're gonna learn from them. Vietnamese national dish is called a pho, and the pho is a big bowl of vegetables with a little bit of minced meat, and it's okay to eat a little bit of meat as long as it's not the core of the dish. So the key concept of the anticancer plate is a huge amount of vegetables with a little bit of meat, the exact inverse of the proportions of what we do when, you know, we try to be nice and do what our doctor says and we eat meat with two green beans, okay, to feel less guilty.

Well, this is the opposite, a big plate of green beans, a little bit of meat on top, if you will. Now, well some of the most effective anticancer foods as I said is the cabbage family, cauliflower, broccoli, brussels sprouts, they stimulate the immune system. They help the body get rid of carcinogens and they limit angiogenesis, and they even induce apoptosis which is cell death in cancer cells, a magical group of foods. The other one in that category is garlic, as I said onion and leeks. In the Mediterranean diets, every dish comes with either onion, garlic or leeks, every dish. Their dessert, don't try that. They have every other dish. And with these herbs, thyme, rosemary, oregano, mints, basil, all of which have carnosol for example as a phytochemical that has been identified to kill cancer cells. It even kills glioblastoma cells, and are powerful antioxidants, and they're added to every dish. They, in terms of proteins, the best source is vegetable proteins such as tofu or beans, lentils, beans, which when combined with whole wheat or whole brown rice or multigrain cereals and bread, actually produce the same set of amino acids, same sets of proteins that you get from meat.

So you can get all of your proteins from eating beans and lentils and a little bit of cereals. It doesn't even have to be in the same meal. If it's in the same day, it is good enough. In terms of animal protein, the best one by far is fatty fish, and don't eat too much of the big fish like, you know, nowadays the swordfish. The FDA tells pregnant women to not eat any swordfish because it's too contaminated by dioxin and mercury and so on. And even tuna is starting to be contaminated, so salmon is a good option. Sardines are great, mackerel, anchovy, the small fish, anchovy. Omega-3 eggs are a good source of animal protein, only as long as they're omega-3 eggs, make sure you get that. And then you can eat a little bit of meat. You see the place, that meat place on my anticancer plate, but the really bad news is dessert or the--Oh, I'm sorry, a word about the fats, the fats. The olive oil is an anticancer agent in and of itself, and you can use it to cook and you can use it for salad, you can use it for everything. In the Mediterranean diet, it's the only source of fat practically that is being used. Canola oil is also acceptable and so is flaxseed oil, but you cannot cook with flaxseed or canola because it becomes oxidized too easily. Omega-3 butter is somewhat acceptable if it's occasional. Now, the bad news that I said is dessert. There is not much dessert on my anticancer meal here because dessert will bring up blood sugar. So you have to stick with mostly fruits, dark chocolate fortunately as long it's more than 70 percent cocoa it’s acceptable and it's actually quite sweet, so you can you know you--a perfect anticancer dessert is warmed up pair with melted dark chocolate on top of it. It's absolutely delicious. You can add ginger for the zinc and the anticancer effect if you want.

This is an incredible study that was done by a cancer researcher from the University of Montreal, who for 20 years was testing new chemical agents as for their potential as an anticancer drug. And he--at one point, his lab was moved from off campus to within the children's hospital of University of Montreal. And he found himself having to walk through the leukemia ward on his way to his office every day. He had a big reputation in Canada as very imaginative and forefront cancer researcher, and sometimes he would be stopped by parents on his way to his office who would say, "Doctor, you know, my little girl is at the end of her rope and we're not finding anything that helps. Is there something you can suggest to us that we could do?" And sometimes we meet children themselves who would stop and then say, "You know I'm not doing well, doc. Do you have something you can do to help me?" And that would turn on his heart and he wouldn't sleep very well. And he kept thinking about all these drugs he was testing knowing that most of them have tremendous side effects that they would never be usable for children.

And one day, he fell upon an article in Nature, the anticancer effects of green tea. And a light bulb went off in his head and he said, "Oh my God, if there are anticancer molecules in foods, these had been proven to be safe for human use for 10,000, some of them are 100,000 years. And this is the direction in which to go." And so he used his 40 million dollar lab to try testing for the first time drops of vegetables here. He purchased a 50-dollar juicer and, you know, he put garlic clove in it, juice it, get a drop of garlic and test that drop of garlic for its anticancer activity in the Petri dish of cancer cells in exactly the same way that he had been testing pharmaceuticals for 25 years. And this is what he saw. This is a line of colon cancer cell. And you see that garlic inhibited a hundred percent of the growth of those cells. The same was true for leeks, scallions, brussels sprouts, cabbage, spinach, [inaudible], asparagus, cauliflower. And some of them didn't work as well. So it wasn't just a matter of putting a drop of anything. As a function of the particular cancer cell line, some vegetables acted much more powerful within others, even though cabbage--cabbage family and onion, garlic, leeks work practically for all of them.

The other thing is that you might say, "Okay, but you know I don't eat only garlic." Good thing for you. [Laughter] What happens when you mix these foods together? Do they still have an effect? Are they still potent in the body? And this is the very good news. There's another study altogether, but it looks at the antioxidant effect of a variety of fruits here. You see orange, apple, grape, blueberry. Each of them has a certain antioxidant effect which goes up as the amount goes up, right? So the more each you eat, the more antioxidant effect you get. The extraordinary news is that when you eat 200 grams of a mixture of all four, you get a much more potent effect than eating up to a kilogram of any one of them independently. When you mix these things up, that same magic we talked about before the synergy takes place. Unfortunately for us as human beings, we generally have a variety of foods in our meals, but it is for us to decide to create that synergy by what we put in our plates. This has consequences on humans. It's not just in Petri dishes.

This is breast cancer prevention. In China, an Australian study was just published this year. They looked at women who didn't particularly eat mushrooms or green tea and this--they had the baseline rate of breast cancer. Then they looked at women who eat mushrooms every day, and there was more than a 50 percent reduction in the risk of them developing breast cancer. Then they looked at women who ate mushrooms everyday and drank green tea, 89 percent reduction in the risk of breast cancer. Talk about cancer prevention, does that--I understand there's a brand new building that was developed here for cancer prevention programs. Now, this is the kind of cancer prevention that I think a lot of people could get into without major difficulties, major costs. And what about cancer genes? Eighty percent of cancer research funds for breast cancer have been invested in the study of BRCA 1 and BRCA 2 cancer genes. Every woman is afraid of carrying those cancer genes. If they have them, they've been told that their risk of getting breast cancer is 80 percent in their lifetime. So it is a big problem. I can't understand that we spend money on this, not only that but it's easier to study because it's a cancer where we have the genetic pathway. But we talked about cancer genes for a long time. This is a study that came out this year, unbelievable, women with BRCA 1 and 2 cancer genes. This is their risk of getting breast cancer, 80 percent. If they eat a large number of fruits and vegetables, their risk goes down by 73 percent. It goes down to 23 percent. And this is a dose response curve as a function of the amount of vegetables that they eat. They reduce their risk.

So, are they cancer genes or are they fast food intolerance genes? Are they genes that manifest themselves when we don't feed them what they want? The same thing is true of men with prostate cancer. Here is another 2009 study. This was the year of debunking the cancer gene idea. These men, who have a COX-2 activating gene, have 5.5 times, 450 percent greater risk of developing aggressive prostate cancer. This is a huge increase in risk. If they eat fish twice a week, their risk of getting prostate cancer in spite of their COX-2 genes is exactly the same as the rest of the population. So are they cancer genes or are they fish eating genes? Just need their fish offerings in order to stay calm. A word about physical activity. Women who exercise 50 minutes, 30 minutes 6 times a week after breast cancer have a 50 percent reduction in their risk of relapse, a huge benefit. The best drug we have which has been called the miracle by the head of National Cancer Institute, Herceptin, a miracle drug, works only for women who have HER2 receptors, and it reduces relapse rate by 50 percent. It doesn't do better, and nothing prevents you from taking Herceptin which is a miracle drug and walking 30 minutes 6 times a week. It could be walking to work and back. Doing marathons doesn't work as well. In fact, it's worse. So you don't need to do marathons.

A few words about the journey of cancer, a lot of women who have breast cancer for example, 40 percent of them believe that it is due to a major stress in their life. Is that true? Is that not true? We don't have any data suggesting a pathway through which stress can cause cancer. And in fact, most oncologists are very aware of all of these studies that show that women with no stress, and they had to go to Finland to find them, you see.

The women with no stress and the women with some stress or a severe stress in their life, have no difference in their risk of developing breast cancer. Most oncologists know that and they tell women, "You know stress has nothing to do with your disease." Now I don't believe that is true. I believe that's an oversight of the data. Now this is an experiment we cannot do with women, [laughter] but we can do with rats. These are rats grafted with cancer cells, a tumor, and left alone in their cage to live their normal life. Fifty percent of them are capable of rejecting the tumor because rats, like us, have strong natural defenses against cancer. Now these rats grafted with the same tumor are put in a cage where they get electric shocks at random times during the day that they cannot control. After about a month, they're completely depressed. You put your hand in the cage, they don't bite. They stop eating. They stop having sex, which for a rat is a really bad sign. [Laughter] And now these rats, the despondent rats, only about a quarter of them are capable of rejecting the tumors. These are the most interesting rats, grafted with the same cancer, put in their cage where they get the same number of random electric shocks. But they're provided with a little lever that allows them, when they press the lever, to avoid extra shocks. So they get as many shocks as these but they have a little tiny bit of control over their environment. And what that does is they don't get depressed. They eat, they have sex and they fight back if you try to get in their cage. And these rats reject cancer better than those who are left alone. So it is not about stress, and that's the mistake of all of these studies that look at, try to look for a link between stress and cancer. It's not about stress and cancer. It's about response to stress and cancer. And if you put all of these together, you might see no effect. If you have some tiny bit of ability to regain control, your body follows suit and fights back with you.

Look at this study, another study in Finland in men. It looked at men who responded in two questions that they were hopeless of their ability to control their future. These men had a cancer mortality that was 2.5 higher within 6 years, 6 years. Mortality, they died of cancer within 6 years with a 2.5 greater risk than the men who didn't say they had any hopelessness. So this is what it's about. It's about the reaction of powerlessness and hopelessness that can help existing cancers grow. And our main defense as human beings against hopelessness is actually, or supports, is the links we have with other people. And if you will allow me, I'd like to read the section from my book. Can I borrow this? Thank you. It's the section I didn't write. So I feel I can read this to you with no self consciousness.

This is about a woman named Mish who had the bilateral mastectomy for breast cancer followed by chemotherapy radiotherapy whose treatment was so harsh that when they ask her, "what was the most difficult time for?" She said is, "When I look at myself in the mirror and I had lost all my hair. I'd lost all my eyebrows. I'd all my eyelids--eyelashes, sorry. Eyelashes, yes. And what I saw in the mirror was a light bulb with no eyes--with eyes--light bulb with eyes." And at the end of that conversation, about how hard it had been for her to go through treatment, I asked Mish, "What is the one thing that helped you bear with that?" And she said, she was a very thoughtful woman, and she said, "You know, I'd like to think about that." And a few days later, she sent me this email, "My husband gave me a card early in my illness which I pinned up in front of me on my bulletin board at work. I read it frequently." Here's what the card said, the cover read, "Open this card and hold it close to you. Now, squeeze." Inside my husband wrote, "You are my everything. My joy in the morning even on the days we don't make love. My sexy and warm and laughing midmorning daydream. My phantom lunch mate. My building excitement at mid-afternoon. My soothing joy at seeing you when I get home. My workout with the compressor. My sous-chef. My playmate. My lover. My all." And the card continued, "It's going to be just fine." He wrote under that, "And I'd be there at your side always. Love PJ." He was by my side every step of the way. His card meant so much to me and guide me throughout my journey, since you asked, thank you. We don't all have a PJ in our lives neither do all of our patients. However, we now have studies showing that what matters is as helping hand or a set of helping hands of friends, a network of friends count as much if not more then a single intimate partner. And this is not just a psychiatrist saying this at the top of my head.

These are studies, same thing, the Australian study, 515 women perspective, women with no stress they do have some in Australia, woman with a major stressor in their life, no difference in the risk of breast cancer. Women with no intimate support, no difference in the risk of breast cancer. Now combine the two, the major stressor and no support, 9.5 times the risk of getting breast cancer. It is the powerlessness and the face of stress in views by the lack of connectedness that can contribute to the risk of cancer. So to conclude, that leaves us with a very different picture of cancer than the one I learned in medical school and the one I learned from my oncologists.

And I think most people who are familiar with the biology of cancer are very comfortable with this picture even if it hasn't yet taken hold in the way we practice oncology. This is what happens, cancer is nothing but the lost of equilibrium. The lost of balance between two powerful forces in the body. On the one hand, the promoters of cancer growth of which I don't even mention tobacco and alcohol because everybody knows that that more recently identified ones like sugar and white flour that help promote cancer growth. Like omega-6 fatty acids that have become abundant in American diet with 20 times more omega-6s and omega-3s in the average American diet, chemical pollutants that either cause or promote cancer growth or sedentary lifestyle and/or powerlessness in the face of adversity. But on the other side, here are the cancer growth inhibitors. The anticancer phytochemicals that reduce like garlic reduces the rise of blood sugar of your meal.

The omega-3s that counterbalance the--the inflammatory effect of the omega-6s. The phytochemicals from food like broccoli that detox the body of the chemical pollutants that can contribute to creating or promoting cancer. Physical activity stimulates immune system, detoxifies, reduces insulin and blood sugar rises, and social support and stress management. Now, all of us in this room can do little inventory. Where do I stand on this column? Where do I stand on this column? And this is the picture that tells us how I can reduce my likelihood of developing cancer or if I have it, of making me grow. I wanna conclude on one idea.

As a physician, I am very concerned about the idea of giving people false hopes, because I know this betrayed the only thing that is truly fundamental which is the authenticity of my relationship to a patient. And I don't wanna have false hopes for myself. I need authenticity in the relationship to myself as well. However, when we do not tell our patients or we did not tell ourselves about all of the scientific information that shows that there are powerful ways in which we can regain control of our faith in our fight against cancer, then what we are doing is inducing false hopelessness. And all of what I am trying to do today, for this book really has talked about all of my actions, is to fight against false hopelessness. Thank you very much for your attention.

Thank you.

Cohen: We have time for questions and I think--are there microphones? Oh, those microphones in the middle of the aisle.

Servan-Schreiber: There's a gentleman with a child there. You might wanna give it to him first 'cause he may not be able to stay very long. [Chuckles] I don't know.

Audience: She just woke up. So the risk of running is increasing.

Servan-Schreiber: Right.

Audience: Thank you so much by the way for the information. I was gonna ask you two questions. The first one in two parts, but you already addressed the stress part of it. The second part was going to be--is the--what about the chemicals we breathe? Are they a factor in all of these? And the second question is the BPA and heated material, heated plastic, is there a risk in BPA--of BPA in non-heated plastics, a water jugs that are made of hard plastic?

Servan-Schreiber: Okay. What was the first question?

Audience: Chemicals we breathe.

Servan-Schreiber: Yeah. Chemicals we breathe. They actually--we did it somewhat but nearly as potently as the ones that are provided, you know that we get in to us from food and direct exposure. But there could be some because we, you know, we find some of the chemicals that are--the anti-burning, the fire protectors that are part of our computers. You find them in our bodies. So they have to be coming through breathing. So it does happen as well. The second factor is BPA in plastics with not in contact with the hard liquids. Unfortunately, that is true. The hard plastics that are--that we use for water bottles, you know the--a lot of them are used for sports bottles, for example. When--with extensive use as they aged, they start leaching out BPA. And the very sad fact and I learned this very recently is that the jugs we use in our water coolers in our offices are made of hard plastic PVC and they do leach out BPA after a while. Now, I wanna say one reassuring thing about this and I thought of making a slide, they already have so many that didn't--there is a recent study that showed you the very negative effect of BPA, animals, especially if during--if they are exposed in utero and it turns out to be completely cancelled if the animals also eats soy, do understand? So some the things you eat, if you have improper diet, a Mediterranean-type diet might be canceling out the adverse effects of some of these chemicals. So this is a very, you know, positive message. I mean, I still think we should reduce our exposure to BPA. Don't get me wrong. But at least we feel less powerless when we know that we can compensate for the exposure that we can't avoid by making sure we have the diet that is very rich in these phytochemicals. And the one point I wanna make 'cause I know I was pretty harsh on pesticides a year but I want to be clear--I'm gonna do the Obama thing, "Let me be clear. [Laughter] Make no mistake. Make no Mistake." Eating broccoli with pesticide residues on it is much better than not eating broccoli. So you know, don't say, "I'm not gonna have the vegetables because it's not organic. Eat the vegetables because the phytochemicals in the vegetables are much more powerful than the rat pesticides residues that maybe on them, okay. Lady.

Audience: What is your opinion of canned salmon, canned sardines, those kinds of seafoods?

Servan-Schreiber: Yes. I would say it's the same. Unfortunately, as I said, "Canned foods contains BPA." So if you're gonna eat canned foods, make sure that its canned foods that are extraordinarily rich in anticancer substances. And canned sardines, I would place in that category. I think it is good anticancer food. I'm hoping that, you know, the makers of this cans will wake up to the fact that they don't--they could do it without BPA. And I'm actually involved in a European campaign to trying to eliminate BPA from canned foods. But for the moment, we'd still say eat canned sardines as long as--did you follow what I said, "What kind of oil should they be in?"

Audience: Olive oil.

Servan-Schreiber: Olive oil.

Don't get canned sardines in sunflower oil because that's defiling the purpose. By the way, I didn't tell you that but, you go home tonight, look at your kitchen cabinets and there may be sunflower oil--there maybe sunflower oil, there maybe corn oil, what can you do with that? Well, cannot give it to the neighbors.

Cannot give it to your kids. There's only one option, and that's the trash and replace that with olive oil as early as tomorrow morning. Oh, I didn't tell you about scratch Teflon also, while you are looking at your kitchen, you know, impeccable Teflon pans seemed like they might be okay, but scratch Teflon makes the Teflon get in to your body as soon as you cook food in there. So same thing, can't give to your neighbors. I know you love that pan. You know this walk is beautiful, can't give it to your neighbors. You need to throw it away and get a new one. They no make special pans with non-stick with no Teflon that work wonderful. One brand is called "Green Pan." Green Pan, it's a low expensive but it's wonderful. Yes.

Audience: What is BPA?

Servan-Schreiber: BPA is Bisphenol A. It is the substance that is used in--to make plastic hard. So it's found in hard plastics. Yes.

It's PVC. It's part of PVC plastic, polyvinyl chloride plastic, PVC. Yes.

Audience: I'm looking forward to some grass-fed beef tonight and it needs some red wine with it, and I'm wondering what you're thinking is on red wine now?

Servan-Schreiber: Very interesting. Thanks, bringing me the opportunity to give good news. They--alcohol in general is linked with and increased risk of cancer, okay. Make no mistake and do that all again. Alcohol is linked with an increase risk of--almost all cancers, particularly head and neck. Except red wine, but only in one circumstance, a red wine drink during a meal and not more than two glasses per day. If you step outside of those limits, red wine becomes carcinogenic as well as other forms of alcohol. Yes.

Audience: Outside of meal?

Servan-Schreiber: Outside of meal is no good. If you drink it outside of meal, drink it with a little bit of protein. Eat some almonds or--not the pretzels or, you know, the stuff here, but eat a little bit of something that will reduce the impact of the alcohol.

Cohen: One last question.

Servan-Schreiber: Oh, you pick. This is the last question today. [Laughter] The responsibility is too heavy on me. Who is that?

Audience: What are you writing on your cookbook?

Servan-Schreiber: What am I writing a cookbook?

That's right. Many thanks. I'm actually working on the cookbook right now which would be sort of an appendix to this book and it's been a lot of fun to think about this recipes. And this is what I eat everyday so I do have a do's about that. So unfortunately, we're gonna end on this note and then I'll be signing books.

Yes, so thank you so much.

Cohen: Thank you.

Dr. Servan-Schreiber will be here for another while signing books outside. Thank you all so much for coming. And special thank you to the friends of Integrative Medicine who are here tonight.

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