Nutrition, exercise, and inflammation
 

Hi,

I would be interested in any trials being offered or any trial information (pro or con) related to the combination of nutrition, exercise, and inflammation.

Diet - After being consistently on a low glycemic diet of mostly whole grain products, fruits, vegetables, a few walnuts, fish and chicken, olive oil and daily freshly ground flax seed -- buying as much of the foods as organic as possible, avoiding simple sugars -- no alcohol, no caffeine -- getting natural sunshine as frequently as possible as well as supplements in keeping my vitamin D level around 40 -- and supplementing with CoQ10, fish oil, and magnesium….

Exercise - Rope jumping 30 minutes a day 7 days a week (until a recent minor back strain)

Lab Results - My lipid panel shows low triglycerides, high HDL, above normal LDL, and above normal total cholesterol. My markers (CA 15-3 or CA 27.29, CA-125, and hs-CRP) are all low.

Therapy - My PCP was sure I would need to take a statin until we used as a tie-breaker the hs-CRP; results came back not only not high or medium risk, but LOW risk. I had CAFx6, rads, and 1 3/4 years of tamoxifen, but no trastuzumab or other treatment. As a stage T1c I've had no known recurrence of cancer.

QUESTION: By using the markers as a rough estimate, it appears to me that keeping my level of inflammation low may be a meaningful way to avoid recurrence. I would be interested in any information about possible trials or other information regarding the use of diet and exercise and inflammation markers, in order to reduce inflammation to avoid recurrence.

Thank you,

AlaskaAngel

Re: Nutrition, exercise, and inflammation
 

Thanks, AlaskaAngel, for the information on how to avoid recurrence.

I've heard of people taking daily low dose of Aspirin to reduce inflammation and prevent cardiovascular disease. I wonder if there's study on its effect on reducing cancer recurrence.

Re: Nutrition, exercise, and inflammation
 

I don't know if Aspirin can help, but I did learn that cox 2 inhibitors, both conventional and natural cox2 inhibitors can help. I wonder what Tanya would say about this?

Re: Nutrition, exercise, and inflammation
 

I am a believer in the benefits of anti-inflammatory diet and lifestyle. I have done a review of the current literature and while I can't produce reams of data directly linking cancer and inflammation I think some of it is just common sense. Our typical American diet consists of far too many Omega 6's and 9's which both lead to inflammation and not nearly enough Omega 3's which reduce inflammation. To top it off 65% of our adult population is either overweight or obese also promoting inflammation. Additionally, there are many components in our environment that also promote inflammation.

Cox-2 inhibitors (aspirin, tumeric/curcumin, etc) are known to be anti-inflammatory and may have some benefit in cancer prevention and prevention of recurrence although I can't say the research is definitive. I think we are safe to say that a diet rich in Omega-3 fats, high in fruits, vegetables and whole grains, moderate in calories (portion size) is excellent for just about anyone. I am pasting a nice article from the AICR newsletter from Fall 2008 addressing the issue and an anti-inflammatory pyramid from Dr. Weil's website. Please note on the pyramid that soy is included but may not be appropriate for everyone. The same is true for "supplements". I believe it is best to get nutrients from diet whenever possible.

http://www.aicr.org/site/DocServer/S...pdf?docID=2541

http://www.drweil.com/drw/ecs/pyrami...odpyramid.html

Re: Nutrition, exercise, and inflammation
 

Thanks, Tanya, for the prompt response, and for your participation here.

I do use spices and herbs in that I use daily cinnamon and turmeric in my hot drinks and hot cereal and nightly 1% organic milk plus stevia plus freshly ground flax seed (but I don't take them as a pill supplement). As a stage I, HER2+++, 50% ER+ and 95% PR+, I have used the flaxseed for over 4 years, although some may choose not to.

It is interesting to me that the food pyramid recommends against the white button mushroom and I am curious to know if you know why, as I have been waiting for a trial for that mushroom to get off the ground and it now is an actively running clinical trial.

I will list some of the active clinical trials, in case anyone is able and interesting in participating or watching for their outcome:

These are the trials that came up for me today on the clinicaltrials.org database using breast cancer as the disease, and mushrooms:

White button mushroom trial

http://clinicaltrials.gov/ct2/show/NCT00709020?term=mushrooms&cond=%22Breast+Neoplasm s%22&rank=1

Yunzi extract trial (any folks from Barcelona, Spain on our forums?)

http://clinicaltrials.gov/ct2/show/NCT00647075?term=mushrooms&cond=%22Breast+Neoplasm s%22&rank=2

Coriolus versicolor trial (University of Minnesota, Bastyr University Sponsors)

http://clinicaltrials.gov/ct2/show/NCT00680667?term=mushrooms&cond=%22Breast+Neoplasm s%22&rank=3


These are the clinical trials that came up for me today for the clinical trials.org database using breast cancer as the disease, and omega-3:

For the newly diagnosed (trial based in Oregonn, do we have any newly diagnosed folks in Oregon who are interested?

http://clinicaltrials.gov/ct2/show/NCT00627276?term=omega-3&cond=%22Breast+Neoplasms%22&rank=4

For the non-metastatic patients… a trial Columbia University and…. Glaxo-Kline-Smith (!) are offering, using omega-3 for musculoskeletal joint pain an stiffness in those on aromatase inhibitors

http://clinicaltrials.gov/ct2/show/NCT00930527?term=omega-3&cond=%22Breast+Neoplasms%22&rank=3

For those interested in any synergistic effect of use of the antiestrogen use of raloxifene and omega-3, offered through Penn State:

http://clinicaltrials.gov/ct2/show/NCT00723398?term=omega-3&cond=%22Breast+Neoplasms%22&rank=2

This trial is in progress and is not looking for participants, but one to keep an one on…. for those who haven't had breast cancer and want to see of omega-3's help to keep it that way -- offered through Cedars-Sinai Medical Center.

http://clinicaltrials.gov/ct2/show/NCT00114296?term=omega-3&cond=%22Breast+Neoplasms%22&rank=1

Re: Nutrition, exercise, and inflammation
 

I am excited to see the white button mushroom study and will be even more excited to see the results. I believe that traditionally they are considered to have little nutritional benefit, especially in comparison to their Asian counterparts. The Asian variety mushrooms have some unique antiviral properties and very high antioxidant content. Thanks for the summary of current clinical trials for the mushrooms and omega-3's. This is very helpful and exciting information.

Cox-2 inhibitor search results for clinical trials (both active and completed)
 

Hi Jackie07,

Clinical trials for cancer don't always involve taking extreme medications like the ones used for chemotherapy, and I wish more people would take the time to consider helping out by participating.

There are 25 trials listed on clinicaltrials.org by using the search terms Cox2 inhibitor after choosing breast cancer as the disease.... Many are completed trials, and some are not recruiting, but they are still worth considering in trying to find out the results. I won't copy them all here, but they are really interesting. The one that caught my eye (because it is in Seattle and I go there) was the one about Cox2 inhibitors and mammogram density that is offered at Fred Hutch cancer center:

http://clinicaltrials.gov/ct2/show/N...sms%22&rank=22

1Not yet recruiting Perioperative Administration of COX 2 Inhibitors and Beta Blockers to Women Undergoing Breast Cancer Surgery: an Intervention to Decrease Immune Suppression, Metastatic Potential and Cancer Recurrence Condition: Primary Operable Breast CancerIntervention: Drug: Propranolol, etodolac2Active, not recruiting Vinorelbine and Celecoxib in Treating Women With Relapsed or Metastatic Breast Cancer Condition: Breast CancerInterventions: Drug: celecoxib; Drug: vinorelbine ditartrate3Completed A Study of Women With an Early Diagnosis of Breast Cancer, Taking Celecoxib Between the Biopsy and Lumpectomy/Mastectomy Condition: Breast CancerIntervention: Drug: celecoxib 400 mg bid4Active, not recruiting Protocol for Women at Increased Risk of Developing Breast Cancer Condition: Breast CancerInterventions: Drug: celecoxib; Other: placebo5Recruiting Exemestane With Celecoxib as Neoadjuvant Treatment in Postmenopausal Women With Stage II, III, and IV Breast Cancer Condition: Breast CancerInterventions: Drug: Exemestane; Drug: Celecoxib6Completed Celecoxib in Preventing Breast Cancer in At-Risk Premenopausal Women Condition: Breast CancerIntervention: Drug: celecoxib7Completed Biomarkers in Women Receiving Chemotherapy and Celecoxib for Stage II or Stage III Breast Cancer That Can Be Removed by Surgery Condition: Breast CancerInterventions: Biological: filgrastim; Drug: capecitabine; Drug: celecoxib; Drug: cyclophosphamide; Drug: docetaxel; Drug: doxorubicin hydrochloride; Genetic: gene expression analysis; Genetic: polymorphism analysis; Genetic: protein expression analysis; Genetic: reverse transcriptase-polymerase chain reaction; Other: imaging biomarker analysis; Other: immunohistochemistry staining method; Other: laboratory biomarker analysis; Other: pharmacogenomic studies; Procedure: dynamic contrast-enhanced magnetic resonance imaging; Procedure: needle biopsy; Procedure: neoadjuvant therapy; Procedure: radiomammography; Procedure: ultrasound imaging8Active, not recruiting Celecoxib in Treating Postmenopausal Women Who Are Undergoing Surgery for Invasive Breast Cancer Condition: Breast CancerInterventions: Drug: celecoxib; Procedure: conventional surgery; Procedure: neoadjuvant therapy9Recruiting Study on the Neoadjuvant Use of Chemotherapy and Celecoxib Therapy in Patients With Invasive Breast Cancer Condition: Breast CancerIntervention: Drug: celecoxib and chemotherapy10Recruiting APRiCOT-B: Study to Evaluate Apricoxib in Combination With Lapatinib and Capecitabine in the Treatment of HER2/Neu+ Breast Cancer (TP2001-202) Condition: Breast CancerInterventions: Drug: apricoxib + lapatinib + capecitabine; Drug: placebo + lapatinib + capecitabine11Recruiting The Effect of Aspirin on Angiogenesis Proteins in Women on Tamoxifen Therapy Conditions: Breast Cancer; AngiogenesisIntervention: Drug: Aspirin12Recruiting A Study of the Effects of Inhibiting Platelet Function on Circulating Cancer Cells in Breast Cancer Patients Condition: Breast NeoplasmsInterventions: Drug: Plavix/Aspirin; Other: No Intervention13Active, not recruiting Letrozole and Celecoxib in Treating Postmenopausal Women With Locally Advanced or Metastatic Breast Cancer Condition: Breast CancerInterventions: Drug: celecoxib; Drug: letrozole14Active, not recruiting Exemestane + Celecoxib vs Exemestane + Placebo in Metastatic Breast Cancer Condition: Metastatic Breast CancerInterventions: Drug: placebo; Drug: Celecoxib; Drug: Exemestane15Completed Open-Label Study Of Exemestane With Or Without Celecoxib In Postmenopausal Women With ABC Having Progressed On Tamoxifen Condition: Breast NeoplasmsInterventions: Drug: Celecoxib; Drug: Exemestane16Active, not recruiting Sulindac in Preventing Breast Cancer in Women at High Risk for Breast Cancer Condition: Breast CancerInterventions: Drug: sulindac; Other: laboratory biomarker analysis17Completed Safety, Efficacy and Pharmacokinetic Between Capecitabine and Exisulind in Metastatic Breast Cancer Patients Conditions: Breast Neoplasms; Metastases, NeoplasmInterventions: Drug: Capecitabine; Drug: Exisulind18Completed Celecoxib in Preventing Breast Cancer in Premenopausal Women Condition: Breast CancerInterventions: Drug: celecoxib; Other: placebo19Active, not recruiting Celecoxib in Treating Women With Metastatic or Recurrent Breast Cancer Condition: Breast CancerIntervention: Drug: celecoxib20Completed Celecoxib and Trastuzumab in Treating Women With Metastatic Breast Cancer Condition: Breast CancerInterventions: Biological: trastuzumab; Drug: celecoxibGiven that women are prone to heart disease as well.... and the effects of anti-inflammatory treatment on that... all very interesting.

AlaskaAngel

Re: Nutrition, exercise, and inflammation
 

Thanks for all the great links and great information. It is very useful.

Re: Nutrition, exercise, and inflammation
 

Tanya,

I was wondering if you might have access to this article, and if so, whether you could read it and discuss it with your counterparts and then give us your general impression of it and what it says:

Exercise, Inflammation, and Innate Immunity
Immunology and Allergy Clinics of North America, Volume 29, Issue 2, Pages 381-393
J. Woods, V. Vieira, K. Keylock

Abstract
Exercise has beneficial effects on chronic disease, and the drive to understand the mechanisms of these benefits is strong. This article presents several compelling potential mechanisms for the anti-inflammatory effect of exercise, including reduced percentage of body fat and macrophage accumulation in adipose tissue, muscle-released interleukin-6 inhibition of tumor necrosis factor-a, and the cholinergic anti-inflammatory pathway.

Re: Nutrition, exercise, and inflammation
 

Hi AA. I wasn't able to access the article but posted it on a listserv I belong to in hopes that someone else has access and can send me the article. I will let you know if I get it.

Re: Nutrition, exercise, and inflammation
 

Thank you, Tanya. I'm very curious about what they are learning. Did you happen to see Donna's post on the main forum about the omega-3 testing? I'm thinking, though, that testing omega-6 levels would be key.

A.A.

Re: Nutrition, exercise, and inflammation
 

Tanya, here is an example on the web site I gave StephN, which shows not only glycemic index but also the inflammation factor for whatever food is selected:

London broil, or round steak:

http://www.nutritiondata.com/facts/beef-products/3569/2

Whole grain bread:

http://www.nutritiondata.com/facts/b...roducts/4846/2

Re: Nutrition, exercise, and inflammation
 

AA,
I just looked at Donna's posting. Thank you for directing me to it as I usually don't look much beyond the Diet and Nutrition postings. I have emailed the company that does the testing to see if they will send me some background on the Omega Score testing. Also, I received a copy of the Exercise and Inflammation article and in the process of reviewing this for you.

Re: Nutrition, exercise, and inflammation
 

AA,
I have had an opportunity to review the following article.
Exercise, Inflammation, and Innate Immunity
Immunology and Allergy Clinics of North America, Volume 29, Issue 2, Pages 381-393
J. Woods, V. Vieira, K. Keylock

It is a fascinating article that summarized a multitude of exercise, inflammation, and immunity studies. What I gathered from the article was that it is our own immune response to stress that aids in creating chronic inflammation, particularly macrophage response. It is known that this chronic inflammation may be linked to many chronic illnesses (cardiac, arthritis, metabolic syndrome, etc). The article was not directly oncology related but I believe has application. I will bullet point of few of the areas I found interesting.
-Increased physical activity is an effective means of reducing systemic low-level inflammation (chronic) as well as acute inflammation. Acute inflammation can be reduced with exhaustive or moderate exercise. They noted it was important to avoid "over training" which of course can lead to more inflammation.

-Researchers used a mouse model and found that daily strenuous exercise had an anti-inflammatory effect on allogeneic tumor growth. It did not effect maximum tumor size but slowed growth of the tumor and lead to more rapid regression of the tumor.

-Exercise many be an effective way to decrease the inflammation profile that is a normal progression of aging.

-Longitudinal studies have indicated that exercise training has an anti-inflammatory effect for individuals who have chronic diseases (cardiac, metabolic syndrome, overweight but otherwise healthy kids and adults). CRP levels show significant decrease with moderate exercise (again, avoid overtraining)

-Exercise appears to be a key component in reducing inflammation as opposed to just diet alone although the author admits this needs further investigation. It was indicated that diet alone did not lead to as significant decrease in inflammation compared to exercise but was poorly studied.

Bottom line was that they know there is a connection between exercise and inflammation but they haven't yet figured out the exact immune mechanism.

I haven't heard back regarding teh Omega Score testing company yet. If I do I will post.

Re: Nutrition, exercise, and inflammation
 

Thank you very much for taking time to review it and get back with your comments, Tanya.

As noted, avoiding over-training is important. I wonder in what way the exercise involved might have worked for Lance Armstrong's prolonged remission.

(puff puff puff puff)

A.A.

Re: Nutrition, exercise, and inflammation
 

Interesting though about Lance Armstrong. Keep going! :-)

Re: Nutrition, exercise, and inflammation
 

AA, Tanya and everyone,
Please see new thread I posted in HER2 Group, citing Cure magazine article on role of chronic inflammation in cancer development.

http://her2support.org/vbulletin/showthread.php?t=41537

It suggests there that some of us with overactivated immune systems need a way to turn it DOWN. Some very interesting information there regarding the role of common conditions that result in continuously activated immune systems and what that could mean in the cancer cell microenvironment.

Check out that chart of common diseases and conditions.

Re: Nutrition, exercise, and inflammation
 

Thanks, Steph! Translating this into practical ways of changing the diet is challenging, but interesting.

A.A.

Re: Nutrition, exercise, and inflammation
 

Dear Tanya,
the survivors are thinking that Boswellia is good.
But all drugs with Boswellia includes something more - for example, also Commifora mukul, Paederia foetida, Vitex negundo, Apium graveolens, Trachyspermum ammi, Cyperus rotundus. Such a mix! But Boswellia prevails, it's 1:3. Are these components eligible for treatment?

Re: Nutrition, exercise, and inflammation
 

Unregistered,
Please clarify your question.