THE BIOLOGY and ENVIRONMENTAL
EPIGENETICS OF CANCER
Mitchell Gaynor, MD
Founder and President,
Gaynor Integrative Oncology
Assistant Clinical Professor of Medicine,
Weill-Cornell Medical College
Scientific Advisor
Environmental Health Trust
Cancer and Environment

One in 3 Americans will hear
the words “You have cancer”

More Americans are surviving
cancer – 9.8 million Americans
in 2001 vs 3 million living with
cancer in the early 1970s
Cancer rates are increasing in
many categories:
- In 2003 cancer cases in US
increased 3.8%
- Non-Hodgkin Lymphoma rates
tripled since 1950’s
- 1 in 7 women now develop
breast cancer, compared to 1 in
22 in 1940

NEJM Twin Study

Identical twins developed same
disease only 10% of the time

Both develop either breast,
colon or prostate cancer 14 –
30% of the time
New England Journal of Medicine, 2000
Are we born with our genetic
destiny or can it be changed?
Agouti mice-- epigenetic changes
carried across generations
(Waterland and Jirtle, Mol.Cell.Biol.23:5293-5300,
2003) (Env.Health Perspect 2006 April,114(4) 567572)
Nutritional genomics vs.
toxicogenomics
Epigenetics :DNA
methylation and
histone
modification
Inherited Breast / Ovarian Cancer
BRCA1 or 2 Mutation
Future of Predictive Genomics


Women have an 82% lifetime risk of breast or
ovarian cancer
Risk has increased since 1940

Risk of breast cancer 24% if born
before 1940 but 67% if born after
1940

Risk of ovarian cancer was twice as
high for BRCA1 carriers and 23%
higher for BRCA2 carriers if born
after 1940
King et.al Science 24 October 2003 Vol.302 P 643-646
Toxic Compounds: Present in
Over 75%
of All Samples Tested by the
EPA
 Since
1976, the Environmental Protection
Agency (EPA) has been measuring toxins
from fatty tissue of both autopsies and
patients undergoing elective surgery in the
U.S.
 20 toxic compounds, including OCDD (a
dioxin), styrene,1,4-dichlorobenzene,
xylene, toluene, DDE and PCBs were
found in more than 75 percent of all
PBDEs
Polybrominated diphenyl ethers

Mandated Flame retardant

Used in upholstered
furniture, foam
mattress and cushions

Associated with disruption of thyroid
function, slowed brain development, cancer
PBDEs
(polybrominated diphenyl ethers)


Ethers that are used as flame
retardants
Levels in harbor seals increased 100
fold between 1989 and 1998

Levels in human tissue in US were 10-40
times as high as levels reported in earlier
Swedish study

Levels of PBDEs are now doubling
every 5 years
San Francisco Bay Area – Breast tissue samples of
women showed highest levels in the world, up to 25 x
greater than European samples
Petreas, Myrto et.al. Env. Health Perspective, Vol 3, No. 9, July 2003
Phthalates

Endocrine disrupting chemicals used in
plastics to make them softer

Found in nail polish, soft plastic toys for
infants, solvents, flavorings, perfumes,
skin moisturizers


PHP linked to birth
defects and reproductive
impairment in animals
PHP - common
phthalate in hair sprays,
cosmetics, shampoo
Tips for the Home

Avoid microwaving with wraps which
contain dangerous plasticizers

Tupperware, rubbermaid bowls
are made from polyethylene
are safer options

Avoid upholstered furniture or foam products that
have been treated with PBDEs. None of Ikea’s
upholstered furniture contains PBDEs.
Tips for the Home

Heating plastic wrap with olive oil in a microwave
results in concentration of xenoestrogens 500,000
times greater than the minimum amount of estrogen
needed to induce cancer cells in a test tube.
x
Bottom line – Never
microwave in plastic
or cover in plastic
wrap. Use glass or
ceramic containers
instead
Tips for the Home

Avoid dishwasher detergents
with chlorine and phosphates
that release volatile organic
compounds as vaporized
mist
Practice Safe Phone and Safe Tech
Distance is your friend
Avoid using phones with weak signals
Do not keep phones next to the body
Use wired rather than wireless when possible
Use speakerphone or wired headsets
Sleep in the dark & quiet
Tips for the Home

Baking soda will clean sinks,
tubs and toilets

Vinegar in a pump-spray bottle
cleans mirrors, windows and
chrome
Tips for the Home
+

Vegetable oil with lemon juice is
good furniture polish

Use non-chlorine bleach
Tips for the Home

Chlorine bleach is potentially carcinogenic and toxic
to lungs.
Its byproducts that contaminate air : chloroform,
trihalomethanes and chlorinated hydrocarbons
Other chemicals in chlorinated products
act as xenoesrogens, thus increasing
risk of breast cancer
Tips for the Home

Hydrogen peroxide – a
better choice than bleach –
breaks down to hydrogen
and water

Bleaches made from
hydrogen peroxide now
available
Tips for the Home

Borax is safer laundry
detergent

Use non-bleached coffee
filters

Skip synthetic air
fresheners – use all
natural scented oils and
candles
Tips for the Home

Minimize dry cleaning which
uses chlorinated chemicals


Hardwood plywood
paneling and particle board
used in shelving omit VOC’s
either in wood itself or from
resins and glues used to
hold them together
Look for solid wood
products certified by the
Forest Stewardship Council
Contact Organic Trade
Association for more
info at www.ota.com
DETOXIFYING ENZYMES and
BREAST CANCER
 JOHNS


HOPKINS UNIVERSITY STUDY
Compared genetic detoxifying enzyme ability
of 110 patients with breast cancer vs. 113
controls
Abnormal glutathione-S-transferase genes
causing decreased enzyme activity resulted in
a fourfold increased risk of breast cancer
(Helzlsouer, K. et al., J. Nat. Can. Inst. 1998)
JAMA January 12, 2005 - Vol 293, No 2
Hyperglycemia and
Cancer Mortality
Elevated fasting serum glucose levels
were associated with a 27% increase
in cancer mortality among men and a
31% increase among women.
Cancer, Diet , Causes
Inflammation/Mediators
Oxidative Overload
Glycemic Overload
Detoxification
ALPHA-LIPOIC ACID
Antioxidant that helps reduce free radicals
 Improves insulin sensitivity, reduces
insulin resistance
 Appears to improve glucose transport
 Dosage: 200-800mg daily

ANGIOPREVENTIVE
COMPOUNDS
ANGIOPREVENTIVE
COMPOUNDS
Araldi EM et
al. Curr
Whole-grains and Cancer
● Fermented in the colon---1)Yields short-chain fatty
acids(SCFA) 2) SCFAs associated with reduced CRP
3) provides immune protection by supporting GALT.
● Improve insulin and glucose responses.
● Bioflavonoids, phytates, lignans, stanols and sterols,
B- vitamins and minerals.
– Ajani et al., J Nutr. 2004 May;134(5):1181-5
VITAMIN D AND BREAST
CANCER
Garland,Cedric et al.(UCSD) AACR 2006
Meta-analysis 1,760 women- 25-OH Vit. D levels
Multiple regression analysis: D3 level>52ng/ml
assoc with 50% lower risk breast CA compared
with levels<12 ng/ml.
Previous study (Prev Med 1990:19:614-22):
Demonstrated women living closer to the
equator, had significantly lower risk of breast
cancer death
SOY ISOFLAVONES AND
BREAST PROLIFERATION




Palomares,M San Antonio Breast Cancer
Symposium(2005) (Poster)
23 postmenopausal breast cancer (Stage I, II, DCIS)
patients at City of Hope National Medical Center
Randomized:Isoflavone tab 100mg/d vs.placebo for 1
year
Bx contralat. breast at 0, 6, and 12 mo:Ki67 index
decreased from baseline in Rx group by 3.1% vs.0.9%
control (6 mo.) and 4.9% vs.4.1% (12 mo.) “Our findings
suggest no negative effects of soy and perhaps even a
beneficial effect”
LIFESTYLE CHANGE-A NEW
PROSTATE CANCER RX ?
 93
men with biopsy proven prostate CA
 Gleason’s score< 7
 All elected to forego conventional RX
 Randomized:
 Vegan diet, exercise, yoga/meditation vs.
control group
 After 1 year PSA decreased in LS group
but increase in control (J.Urol)2005.174(3)
Green Tea and Prostate Cancer







Bertuzzi,S AACR 2005(abstract)
30 men with high grade PIN
Randomized Control vs 600 mg/d green tea
catechins
Bx done at 0 and 12 mo
9 cases prostate CA control and 1 in Rx group at
1 year
The 30% incidence at 1 year is c/w literature
No adverse effects in Rx group
METFORMIN




From diabetes to cancer… via angioprevention?
• It received approval by the U.S. Food and Drug
Administration (FDA) for Type 2 diabetes in 1994.
Metformin is an insulin-sensitizer that reduces
blood sugar levels: it reduces hepatic glucose
output and increases peripheral glucose
metabolism
Cardiovascular benefit(UKPDS and PRESTO
study)
VEGETERIAN PROTEIN SOURCES
Silken Tofu
3oz ¼ block
5 grams/protein
Block Tofu (in water)
3oz or 1/5 block
12 grams/protein
Tempeh
4oz (½ container)
12 grams/protein
Soy milk
8 ounces
10 grams/protein
Soy beans
½ cup
24 grams/protein
Legumes, beans, lentils
½ cup
6 grams/protein
Soy cheese
1 ounce
7 grams/protein
Nuts
¼ cup
5 grams/protein
Eggs
1
7 grams/protein
Yogurt
1cup
10-12 grams/protein
Cheese
1 ounce
7-10 grams/protein
EXERCISE

Aerobic exercise has been shown to reduce
insulin resistance by improving blood supply
to the muscle, which allows for more glucose
uptake into muscle tissue.
 Exercise should be frequent and regular to
be effective.
 Exercise should involve all the major muscle
groups for at least 20-30 minutes 4-5
days/week.
We Cannot Wait for Absolutes
The Precautionary Principle*
We must act on facts and on the most accurate interpretation of
them, using the best scientific information. That does not mean
we must sit back until we have 100% evidence about
everything. Where the state of the health of the people is at
stake, the risks can be so high and the costs of corrective action
so great, that prevention is better than cure. We must analyze
the possible benefits and costs of action and inaction. Where
there are significant risks of damage to the public health, we
should be prepared to take action to diminish those risks even
when the scientific knowledge is not conclusive, if the balance of
likely costs and benefits justifies it.
Source: Richard Horton, Editor-in-chief, Lancet.
*Modified from a 1990 UK Department of the Environment
definition.
Lancet, Vol. 352. No. 9124, 5 July, 1998.
For More Information www.
 DrGaynor.com
 GaynorWellness.com
 DrKathrynCollins.com
 EnvironmentalHealthTrust.org