Richard Klausner Resigns

At the moment that the first plane crashed into the World Trade Center, Richard Klausner, MD was telling a meeting of the National Cancer Advisory Board that he was resigning as Director of the National Cancer Institute (NCI), effective September 30. This otherwise major news item was immediately lost in the pandemonium of the terrorist attacks.

In a letter dated September 7, Klausner wrote to Pres. Bush, "It has not and will not be easy, but real progress is achievable. Our research enterprise is both robust and fragile-it works well but it requires sustained nurturing."

President Clinton had appointed Klausner the 11th NCI director on August 1, 1995. Klausner came in as a reformer after years of stagnation at the agency. Over the past six years, NCI's organization was revamped and many new programs were begun. Science magazine called this "the Klausner Revolution."

What interests me most has been Klausner's influence on the testing of complementary and alternative medicine (CAM) approaches to cancer. This has been mainly positive. After I testified before Congress in February, 1998, and sharply criticized NCI's lack of progress, Klausner called me at home and promised that changes would soon be made. That evening I looked on the NCI website and saw that, as I had asked and he had promised, the very derogatory NCI statements on CAM treatments had been removed. Needless to say, this impressed me enormously.

Klausner was also responsible for setting up the Office of Cancer Complementary and Alternative Medicine (OCCAM), headed by Jeffrey White, MD, which attempts to foster "best case series" by practitioners and carry out evaluations of promising treatments. It is my pleasure to work closely with Dr. White on the Cancer Advisory Panel on Complementary and Alternative Medicine (CAPCAM) of the NIH.

As of October, three of the country's top biomedical jobs are unstaffed: the directors of NIH and NCI, and the commissioner of the Food and Drug Administration (FDA). The appointment of new officials is problematic in the current climate. But here is an opportunity for proponents of CAM to influence the direction of research for many years.

Green Tea Protects Against Prostate Cancer

I have written so many articles in favor of tea (both green and black) that you might think that I am secretly in the employ of the Tea Board! No such luck...but I will continue to preach the value of tea in improving one's health and warding off various diseases. Tea is so commonly available and inexpensive that it is often overlooked by those who are trying to sell high-priced supplements. It is truly "that Excellent and by All Physicians approved China drink," as a text from 1658 once put it.

The preponderance of evidence supports the idea that tea is a particularly healthful beverage. The latest discovery comes from Case Western Reserve University in Cleveland, Ohio. Scientists there gave an extract of green tea to mice that are prone to develop metastatic prostate cancer. The amount of green tea was the equivalent of six cups of green tea per day for humans. The results were striking.

As expected, 100 percent of the mice that received just plain water to drink developed metastatic prostate cancer. But among the mice that got tea to drink there was a significant delay in primary tumor incidence, a decrease in the weight of the prostate, an inhibition of harmful cancer growth factors, and a reduction in some of the markers of proliferating prostate cells. The most striking observation, said Dr. Sanjay Gupta and his Case Western colleagues, was that green tea resulted in "almost complete inhibition of distant site metastases." Furthermore, green tea consumption caused programmed death (apoptosis) of prostate cancer cells, "thereby causing the inhibition of prostate cancer development, progression, and metastasis...to distant organ sites"{PNAS 2001;98:10350-10355}.

There is a prejudice in some circles against all caffeinated beverages, lumping together coffee, tea and cola drinks. I am against cola drinks because I think that excess sugar (or artificial sweeteners) can be harmful. The greatest danger of coffee is probably that it keeps you from regularly drinking tea. Caffeine can certainly be harmful for people with various conditions. But decaffeinated teas are widely available in America.

Some people feel that green tea is much more beneficial than black tea. But there is data that black tea is also worthwhile. Thus, in another recent study, doctors gave patients with coronary artery disease either standard black tea (Camellia sinensis) or water to drink. Patients got about a quart (900 mL) of tea or water per day for four weeks. Both short- and long-term tea consumption improved the dilation of the brachial artery (a good thing), whereas consumption of water had no effect. An equivalent oral dose of caffeine (200 mg) also had no short-term effect on dilation...so it wasn't the caffeine doing it, it was the tea itself. Scientists concluded that black tea consumption reverses some of the dysfunction seen in patients with coronary artery disease. This finding helps explain the well-known association between tea intake and decreased cardiovascular disease {Circulation 2001;104:151-6}.

There is no simple answer to the green tea-black tea dilemma. Green tea has been much more extensively studied in recent years and is in vogue. A quick search of Medline turns up three times as many articles on green tea and cancer (375 articles) vs. black tea and cancer (125 articles). But this may not be because green tea is intrinsically more beneficial. Unfermented green tea is chemically less complex and thus easier for scientists to study. It also offers greater commercial opportunities than black tea, which is so inexpensive that it's almost free!

Fear of Fluoride

Does tea contain fluoride? Yes, it definitely does. But how significant a source is it? And could that amount of this mineral be dangerous? Some people have recoiled from tea entirely because of alarmist reports about it put out over the Internet. I think this is a big mistake. It goes against both common sense and experimental data.

I will not address the issue of whether or not fluoride compounds actually decreases tooth decay. I generally oppose the fluoridation of water supplies because (1) I think the scientific controversy on the use of sodium fluoride is not settled; and (2) I oppose the compulsory and indiscriminate medication of the entire public in this fashion.

However calcium fluoride occurs in many foods. In the USA, fluoride is found naturally (at varying levels) in most drinking water. It is also present in most dairy products, grains, and cereal products. In fact, these three items contribute from 44 to 80 percent of one's daily fluoride intake {Am J Clin Nutr 1980;33:324-7}.

In South Africa, people drink a lot of tea. But the major source of fluoride there is not tea but beer and green leafy vegetables. In Iran, rice and bread...again not tea...are the most important food source of the mineral. Tea provides a third of the average dietary intake. If you are concerned about decreasing your intake of fluoride a good first step would be to drink water that has been filtered by the reverse osmosis process. At many supermarkets you can buy filtered water cheaply. One can also install a reverse osmosis filter in the home.

To be consistent, anti-tea campaigners should also warn people away from well water, beer, green leafy vegetables, rice, bread and dairy products.

Special Warning For Parents

One exception to this rule is children. An excess of fluoride is particularly dangerous to kids. It can lead to fluorosis, which shows up as a mottling or staining of the enamel of the teeth. I would not routinely give tea in any form (not even green decaffeinated tea) to children. This has become an issue because of the many bottled iced teas that are widely available. Some parents regard these drinks as healthy alternatives to cola or other carbonated beverages. But drinking bottled or canned tea is not a good habit for children to develop. One hundred percent natural fruit juices would be a better choice. (An occasional cup of tea, however, will not hurt them.)

Some people have also asked if the process used to remove the caffeine is not more dangerous than the caffeine itself. I don't think so. The most popular method is effervescent decaffeination. In this process, the tea is first bathed in harmless carbon dioxide. This drops the amount of caffeine in an 8 oz. cup of black tea from 60 milligrams (mg.) to just 5 mg. Green tea drops from 30 mg. to 5 mg. as well.

If tea were truly dangerous, you would expect that people who drank it would have more health problems than those who don't. But the opposite seems to be the case. Also, laboratory animals given tea to drink have far less cancer than those that got plain water. Tea contains powerful antioxidants (such as EGCG) and other anticancer substances. It seems likely that tea can be used as a form of "secondary prevention," to prevent metastases. Evidence is mounting that tea (especially green tea) is one of the least expensive and most readily available ways that the average person can help prevent cancer.

Antioxidants Make Progress

There is a huge debate over the advisability of taking antioxidants concurrently with conventional cancer treatments. I have addressed this issue in my book Antioxidants Against Cancer. A new study lends further weight to the affirmative side of the argument. The antioxidant N-acetyl cysteine (NAC) has now been found to prevent damage to the inner ear by chemotherapy. Inner ear cells and their connecting nerve filaments were grown in a test tube. Then they were exposed to the toxic drug cisplatin. As expected, the drug damaged the cells. However, when scientists at the Albert Einstein College of Medicine added a form of acetyl cysteine (L-NAC), they were able to prevent this damage {Laryngoscope 2001;111:1148-1155}.

These scientists conducted an experiment in the laboratory using tissue culture techniques allowing inner ear cells and their connecting nerve filaments to grow. According to the American Cancer Society website, "This study represents a first laboratory step to combat one treatment's side effect." Naturally, additional research studies need to be done before a treatment recommendation can be made to patients. However, scientists can now focus on this area of research and perhaps build on the findings to develop clinical evidence that eventually benefits patients.

This is part of a growing body of literature showing that antioxidants can prevent some of the side effects of chemotherapy. The opposition of many oncologists to the concurrent use of antioxidants and chemotherapy is often based on an irrational fear of alternative medicine.

In addition, scientists at the University of Colorado have found that giving oral folic acid and vitamin B12 injections could reduce the side effects of a new chemotherapeutic agent. The new drug is called Alimta (permetrexed disodium). It is being used experimentally in the treatment of non-small-cell lung cancer, mesothelioma, breast, pancreas, colorectal, gastric, cervical, and head and neck cancers. The drug causes elevated homocysteine levels, which limits their usefulness. But by giving the combination of folic acid and B12 scientists were able to lower homocysteine levels and reduce the severe toxicity of the drug.

Newsletter Endorses Supplements

It is a good sign that scientists at the University of California, Berkeley, have stated their belief that daily intakes of antioxidant vitamins C and E supplements "help inactivate free radicals." The statement comes in a new book, "The Complete Home Wellness Handbook. " The authors include editors of the UC Berkeley Wellness Letter, a monthly eight-page health newsletter published by the university's School of Public Health.

"Consider two antioxidant supplements," the new book advises -- "250 to 500 milligrams of Vitamin C daily and 200 to 400 international units (IU) of Vitamin E. There have been many studies on C and E, and scientists are only beginning to understand how these and other antioxidants work. The evidence is accumulating bit by bit," the authors state.

Vitamin C and Vitamin E "have substantial potential benefits," they write, "including protection against heart disease, certain types of cancer, cataracts, and perhaps other disorders." It is difficult to get the recommended amount of Vitamin E from food, and most foods considered good sources of Vitamin E are high in fat. This recommendation from a newsletter with 400,000 subscribers is bound to shift public opinion towards supplementation.

Sign Up Please

Finally, if you haven't already done so, please take the time to sign up for my free newsletter at www.cancerdecisions.com. Every week you will receive an emailed letter from me with some of the most interesting recent developments in cancer, particularly the use of natural substances to prevent "the dread disease."