Last Updated on May 22, 2023 by Neelam Singh
Cancer encompasses a wide range of diseases that can impact various parts of the body. It is also referred to as malignant tumours or neoplasms. One of the key characteristics of cancer is the excessive growth of abnormal cells that surpass their normal limits. This leads to the spread of the cancer into the neighbouring areas and to other organs, which is called metastasis. The World Health Organization reported that in 2020, cancer was one of the primary causes of deaths globally, with an estimate of about 10 million deaths.
Dr Manish Singhal is a distinguished oncologist in India and is the Senior Consultant of the Medical Oncology Department in Apollo hospital, New Delhi. His expertise lies in all modalities of chemotherapy, immunotherapy, and the management of oncological emergencies along with patient medical care. In a discussion with THIP Media, Dr Singhal spoke about cancer and the role of diet in its treatment and prevention.
Does cancer have a genetic predisposition? If yes, then to what extent?
Cancer can indeed have a genetic predisposition. As our knowledge of genetics has advanced, so has our capacity to conduct tests that can determine whether a particular cancer is hereditary. Some of the commonly observed hereditary cancers are breast cancer, ovarian cancer, colon cancer, and prostate cancer. These genetic forms of cancer may account for approximately 15 per cent of cases on the higher end, while ranging from four to five per cent on the lower end. Whenever a patient is diagnosed with cancer at a very early age or has a significant family history, there arises a suspicion of genetic involvement. In such cases, we proceed to screen these patients for genetic mutations. We then expand our investigation to other family members to establish a comprehensive family tree and identify potential genetic factors.
Are cancers with genetic predisposition treated differently?
The treatment approach remains largely consistent for cancers or tumours with a genetic basis. However, recent advancements have introduced targeted therapies designed to combat specific cancer-causing genes, potentially enhancing treatment outcomes through the use of certain medications. Consequently, there is a significant interest in identifying genetic mutations. This is because this knowledge can offer therapeutic advantages for patients who test positive for such mutations.
Do gene sequencing tests help in preventing cancer in the family?
Indeed, in cases where we identify a mutation in a patient who already has cancer, we administer treatment for the cancer. In some instances, we utilise targeted therapies tailored to combat the specific gene mutations. Once we complete the family tree and discover additional mutations in other family members, we can offer them guidance regarding risk reduction surgeries. For instance, if a female, without cancer, tests positive for a mutation predisposing her to breast or ovarian cancer, she may opt for preventive mastectomy (removal of both breasts) with the possibility of reconstruction at an appropriate age. Additionally, after completing reproductive goals, she can consider the removal of her ovaries.
The primary aim is risk reduction through surgical interventions. Identifying genetic mutations within a family also has a vital role in the implementation of rigorous screening protocols for early detection of cancer. In the cases of colon cancer, we cannot remove the entire colon. But regular screenings such as yearly colonoscopies enable the early identification of cancers at a more treatable stage. Hence, this understanding is crucial in providing individuals with options for risk reduction surgeries and implementing more rigorous methods of screening to detect cancer at an early stage.
To what extent, diet plays a role in prevention or treatment of cancer?
You cannot underestimate the impact of diet on cancer occurrence and predisposition, as the saying goes, “You are what you eat”. To simply put it, red meat can predispose cancer. Not only does red meat leave a significant carbon footprint, it is also difficult to digest. You may have heard from people who eat red meat about the need to drink excessive amount of water. This happens due to the prolonged digestion process. Egg proteins too share this characteristic.
It is important to understand that it is less about your diet being vegetarian or non-vegetarian, and more about how your diet should be. It is crucial to maintain a well-balanced diet. High-calorie diets with a high glycemic index, leading to obesity, pose a higher risk as they can promote the development of tumours. Rapidly increasing blood sugar levels from such diets trigger the body to produce higher levels of insulin. While occasional indulgences are acceptable, it is essential to maintain balance and ensure that foods meant for occasional consumption, such as sugary drinks, do not become regular components of one’s diet.
Obesity, often associated with high-calorie diets and poor food choices, has far-reaching consequences, including an elevated risk of fatty liver disease. People suffering from fatty liver disease face an increased risk of developing liver cancer. Obesity also alters the composition of gut microbiomes, the collection of microbes residing in the digestive system. Such alterations to microbiomes may contribute to an increased predisposition to cancer. A lot of research is happening to study the gut microbiomes that can increase the chances of cancer in a person.
How often do you see a bad diet leading to cancer?
When a patient comes to us, we typically do not delve into their dietary history. However, by examining demographic data, we observe a higher incidence of stomach cancer in regions where spices are a bigger part of the diet. It is important to acknowledge that obesity serves as a significant risk factor for cancer. Any factors that contribute to obesity or elevate the basal metabolic rate (BMR) can potentially contribute to the development of liver cancer, pancreatic cancer, uterine cancer, and even breast cancer. Cultivating healthy eating habits starting from childhood is important to mitigate the risk of developing cancer later in life.
Can alkaline water prevent cancer?
This entire debacle started with a book titled ‘The pH Miracle’, which relied on cell line experiments demonstrating that cancer cells exhibited slower growth in an alkaline environment. An American author wrote the book promoting the idea that alkaline food and water can be used to treat cancer. However, this author was later sued in an American court who served a three-year prison sentence and had to pay compensation. The family of a patient took the legal action. This patient started following the alkaline diet and ceased their oncological treatment, and subsequently suffered and passed away.
It is important to note that our body’s pH is carefully regulated within a range of 7.35 to 7.45 by the kidneys. Regardless of the amount of alkaline water you consume or alkaline diet you follow, you cannot alter the pH value of the blood. It is impossible for alkaline water or food to reach the cancerous cells within the body. Unfortunately, this misconception has gained traction with the endorsement of several celebrities, but it is indeed a myth.
What would be your take-home message for the viewers?
My message to everyone is simply that everything in moderation is fine. Excess of anything can be harmful. There is a saying in Hindi, “Ati ka bhala na bolna ati ki bhali na choop, ati ka bhala na barasna ati ki bhali na dhoop”. Embracing moderation as a way of life should be your guiding principle and mantra.
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