Friday, January 4, 2013

A diet to cure Cancer

Sorry, but there's no such thing as a diet that cures cancer

Professor Karol Sikora
Yesterday, The Marchioness of Worcester announced that an ‘alkaline diet’ — free from alcohol, meat and processed food — had helped her beat cancer.
Here, in an open letter to the Marchioness, eminent cancer specialist Professor Karol Sikora argues that this diet has no power against  the disease — and could  even prove harmful.

Dear Tracy Worcester,

Tracy Worcester has 'never felt better' after following an alkaline diet
Tracy Worcester has 'never felt better' after following an alkaline diet

This week I was so glad to read that you have ‘never felt better’ three years after treatment for breast cancer.
At the end of the day, that is the only thing that matters.
But I have to be honest. 

I don’t agree you owe it all to complementary medicine and ‘alkalining’ your body by eating a diet low in acidic foods.
When it comes to the alkaline diet for cancer patients, I am sceptical.

I’m not averse to patients trying anything — within reason. 

Two of my patients, on their own initiative, are using the alkaline diet, which claims to halt the spread of cancer by making the body fluids more acidic, and they both tell me that it has helped them feel better. 

But I must say there is no evidence that it has made any real difference at all.
Both my patients have done well and treatment is working, but there is no way of telling if they would have done worse without an alkaline diet. 

Cancer therapy these days can be very effective and we expect good results more often than not.
The only way to prove the diet works would be to carry a randomised controlled trial on many different patients — some of whom use it and others who don’t.
As far as I know, that has never been done. 

The alkaline diet, which has its origins in the Twenties, is a loose name for lots of different related diets. 

Lots of people claim to have designed their own version of this diet, but so far none of them have come up with any real evidence that it works.
The concept of an alkaline diet starts with the premise that cancer cells thrive in acidic environments — possibly because this encourages cell mutation — and will shrink and die in alkaline environments. 

Our bodies are normally very slightly alkaline — with a pH of 7.2.
So the idea is you eat lots of alkaline foods, such as squash, lettuce, tomatoes, celery, carrots, onions, chickpeas, spinach, cucumber, basil, parsley, olive oil, lemons, limes and watermelons to raise your pH level to around 8. 

At the same time, you avoid acidic foods such as sugar, meat, dairy products, white rice and pasta and cut out coffee and alcohol.

In fact, if you test your urine on this kind of regime, you may well find that your urine levels are more alkaline than normal. So far, so effective. 

But there are two problems. The first is that the basic premise — that cancer cells thrive in acidic surroundings — is controversial.
Yes, it can be shown in a laboratory, but it has never been shown in human patients.
Fresh spinach
Tomatoes drizzled with olive oil
The idea is that you eat lots of alkaline foods, such as spinach, tomatoes and olive oil, to raise your pH level to around 8

And what happens in a test tube is often very far removed from real practice.
The second thing is the body itself balances pH levels. It doesn’t matter what you eat.

If your pH level rises, the body can alter this back to normal using mechanisms like increasing the pace of breathing and excreting more alkaline through the kidneys. 

The pH balance of the body cannot be changed for any meaningful length of time. Yes, your urine may be more alkaline, but that just shows your body is adjusting and excreting excess alkaline content. 

Looking at you now — glowing with good health — it seems likely that you used a balanced form of the alkaline diet alongside conventional treatments and this is probably the best way to do it.

In theory, the alkaline diet is quite a healthy diet, but not for the reasons you think — and it can’t claim to beat cancer.
It involves increasing your intake of vegetables which are packed with beneficial antioxidants that help to mop up damaging free radicals in the blood.

It also means avoiding saturated fat, which will improve your heart health and reduce levels of bad cholesterol.
But, unfortunately, there are more extreme versions of the alkaline diet which may cause health problems. 

The first priority should always be to make sure you are getting sufficient calories if you are undergoing treatment for cancer — around 2,000 a day.
Any diet which restricts calories is a bad idea.

A balanced version of the alkaline diet does not mean cutting down on the amount of food consumed — just switching to more vegetables and fish instead of pasta and meat — but more extreme versions could mean someone finds it difficult to get enough calories.

I’m also concerned about alkaline diets which cut out all dairy — not the sort you followed where you cut out alcohol, meat and processed food — because this is an important source of vitamin D, vital for bone health. 

Many types of chemotherapy can lead to brittle bones and although we now have medications to try to prevent this, it is important to maintain a diet which is high in calcium and vitamin D. 

You can eat fish and eggs on the alkaline diet, but not red meat. This is also a rich source of iron which is needed for healthy blood production
You can eat fish and eggs on the alkaline diet, but not red meat. This is also a rich source of iron which is needed for healthy blood production

There are also studies that show vitamin D can extend cancer survival rates, although it is not going to cure you if you have metastatic cancer which has spread to the bones already. 

Many sources of protein — which is vital for healthy tissue repair — are restricted or excluded on alkaline diets.
You can eat fish and eggs on the alkaline diet, but not red meat. This is also a rich source of iron which is needed for healthy blood production.

I would hate other cancer patients to start thinking that a radical diet would be a magic bullet because it seemed to work for you, Tracy.

The alkaline diet is not the only questionable cancer-busting diet out there.
I have looked at quite a few faddy diets which claim to help cancer patients over the 40 years I have been practising as an oncologist. 

Some involve eating a huge amount of something like watercress or beans or going to great lengths to avoid certain foods such as dairy products or eggs.
Some people also believe that eating times should be rigidly fixed around the body clock. 

Some eat nothing but sardines and brazil nuts or take a spoonful of bicarbonate of soda with every meal. I can honestly say I have never found one that does what it claims to do. 

Mostly, these diets help people who want to feel they are ‘doing something’ to help themselves when they have a life-threatening disease.

I recently visited the Gerson Clinic in Tijuana, Mexico, where patients — mainly Americans — are on very strict onerous regimes involving having raw carrot juice every hour and coffee enemas.

The clinic overlooks the Pacific Ocean and it is used mainly by people who have run out of other avenues to explore and are already very ill.
It seemed to me the lives of the patients were severely restricted by these measures, when they already had little time left. You could actually say the diet was damaging their quality of life and the quality of life of their nearest and dearest. 

The people who run the clinic say they have evidence that Gerson therapy works, but I can’t find any evidence of scientific credibility.

The link between diet and cancer is complicated, and scientists have not yet unravelled the exact mechanisms involved.

This is because diets are made up of different foods containing many nutrients that interact in different ways in individuals. 

As a general rule, I recommend my patients eat bland foods to settle the stomach and eat little and often if they don’t have the appetite for larger meals.
It is wise to eat more fruit and vegetables and unrefined cereals and to minimise your intake of alcohol. 

You only need two or three portions of red meat each week to stay healthy and you should limit the amount of salt you eat.
But there is no evidence that foods can boost cancer treatment success rates or the effectiveness of chemotherapy.

Another advocate of changing your diet as a cure for cancer is Dr Julian Kenyon, who runs the Dove Clinic for Integrated Medicine in Hampshire and offers help to cancer patients in extremis. 

However, his therapeutic regimes includes some questionable treatments, including elimination diets and photodynamic therapy, which is when diseased cells are exposed to light which causes a series of events in the cell, leading to their destruction.

Certainly, trying to find a cure at the Dove Clinic can cost each patient up to £20,000 — which may be a big financial strain.

I never want to take away hope from my patients and I’m happy for people to explore all avenues to help themselves.
I’ve got one patient who goes jogging after each chemotherapy session and he says it makes him feel great. 

Another eats porridge before she has chemotherapy and says it helps her not to feel sick. 

But doctors have to be careful not to give patients false hope.
The idea there is any magic diet out there which can improve quality of life on chemotherapy or extend survival rates is, I’m sorry to say, a myth.

Yours, Professor Karol Sikora

Professor Karol Sikora is a consultant oncologist based at Hammersmith Hospital in  London and is the founder of, a network  of cancer treatment centres.

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