July 2016    
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Save Yourself from Colon Cancer

First by Diet then by Conservative Screening (Not Colonoscopy)


Worldwide, colorectal cancer is the fourth most common cause of death from cancer, with 1.4 million new cases and 700,000 deaths annually. Almost all cases of this disease are found in people who eat the Western Diet, high in animal foods, vegetable oils, and highly refined, low-fiber plant foods.
Ernst Wynder, M.D. Explains How Diet Causes Colon Cancer


During the weekend of June 30 to July 2, 1978 I attended the first Diet and Cancer Conference held in Seattle, Washington. On Saturday morning I had breakfast with Ernst Wynder, M.D., the man who proved the connection between tobacco and lung cancer to the world. His research was published in the May 27, 1950 issue of Journal of the American Medical Association. As a side note, he told the waitress that he will be having whatever I was ordering, which was oatmeal and fruit. You can listen to my radio interview with Dr. Wynder, (begins at 14:48).


Ernst Ludwig Wynder, MD (1922-1999)


During breakfast Dr. Wynder told me that in 1950 he went to his colleagues, including world-renowned cancer specialists working at Sloan-Kettering Institute for Cancer Research, and told them that smoking tobacco causes lung cancer. Their response, he said, was, "Nah, how could that be?" He explained to them, "When you burn a tube of tobacco multiple times a day and inhale the combustion products (the tars, benzopyrenes and other toxins), they damage the cells in the airways and turn some of them into lung cancer and kill people."


As we were finishing our oatmeal that morning he said to me, "I went to my same colleagues at Sloan-Kettering Institute 10 years later and told them that diet causes colon cancer, and they were similarly mystified. I explained to them that when you put the partially digested remnants of red meat, poultry, processed meats, and other commonly consumed Western foods into the colon, the carcinogenic chemicals from these foods damage the colon's cells and some become cancerous, then spread throughout the body, and people die." That conversation with my mentor, took place more than 35 years ago, and today the general public has no idea that the foods they eat cause colon cancer. Over the next three decades, his work with fellow scientists at the American Health Foundation (which he founded) proved that the Western diet causes colon cancer. They investigated the molecular interactions that occur between the food and the colon and rectum, producing what is commonly referred to as colorectal cancer (CRC).


Denis Burkitt, M.D. Finds No Colon Cancer in Rural Africans


Denis Burkitt, M.D., another important mentor of mine, told me in 1971 that when he served as the head of the governmental health services of Uganda, Africa for 17 years, watching over 1,000 hospitals and more than 10 million people, he never saw a case of colon cancer. The diet of these rural Africans was based on grains, legumes, fruits and vegetables, with no dairy and almost no meat. Watch my interview with Denis Burkitt, found in my January 2013 newsletter.


Denis Burkit, MD (1911-1993)

No one is hearing the obvious: colon cancer is caused by the foods we put into our intestines. This disease is entirely preventable by eating a starch-based diet without animal foods and vegetable oils. Rather, we often hear that the only way to save ourselves from this deadly disease is to have regular colonoscopy exams. Billions of dollars and millions of lives are being wasted annually as the incidence of colorectal cancer (CRC) is rapidly increasing among populations that are adopting Western-style diets.
Looking for Pre-cancerous Polyps


Screening is looking for early disease before it transforms into a deadly form, like cancer. Colorectal cancers arise from benign polyps that occur as a consequence of years of repetitive injuries from partially digested remnants of Western foods (especially meat and poultry), and lack of protective dietary fibers and phytochemicals found in whole plant foods. The rationale for screening programs is to detect and remove these benign precancerous polyps before they turn into tumors with cells that spread via the venous blood system to the brain, lungs, liver, and bones, and eventually kill the patient.


Polyps are common and are estimated to be present in 22% to 58% of asymptomatic, average-risk people who are following the Western diet. Neither polyps nor colon cancer are found in populations following traditional starch-based diets. Progression from polyps (adenomas) to invasive cancer can occur in a little as five years or take more than 20 years (the average is 15 years).






Options for Colorectal Cancer screening:

Testing the Stool for Blood:
            Fecal occult blood test (gFOBT)
            Fecal immunochemical test (FIT))

Genetic testing:
            Fecal DNA analysis (Cologuard)

Endoscopic tests:
            Flexible sigmoidoscopy

            Computed tomography ("virtual colonoscopy" with x-rays)
            Barium Enema (x-ray technique)




Canadians Are Told "No" to Colonoscopy


The Canadian Task Force on Preventive Health Care recommends (as of 2016) screening adults aged 50 to 74 years for colorectal cancer with FOBT (gFOBT or FIT) every two years or flexible sigmoidoscopy every 10 years. These recommendations for screening are considered strong only for people aged 60 to 74 years. People over 75 should not be screened. Therefore, for all practical purposes for you, that could mean one sigmoid exam around age 60, along with testing your stool for blood occasionally.


When using gFOBT, the absolute reduction in death from colorectal cancer is small: 2.7 per 1,000 screened. This means the number of people needing to be screened to prevent one death is 377. By using flexible sigmoidoscopy, the absolute reduction in death from colorectal cancer is 1.2 per 1,000 screened, which means 850 people need to be screened to prevent one death from colon cancer.


These numbers reflect a decreased risk of dying from colon cancer, not from dying (overall mortality). In other words, there is no change in the day you die, on average, from participating in colorectal cancer (CRC) screening programs. One possible reason for this is that the testing itself can kill people. For example, colonoscopy can cause people to die from perforation of the bowel, bleeding, and the anesthesia used. One life saved in exchange for one life lost.


The Canadian Task Force on Preventive Health Care recommends not using colonoscopy as a primary screening test for colorectal cancer—because of lack of efficacy, compared to other screening methods—because of its higher human resource requirements (it requires a specialist such as a gastroenterologist), and greater potential for harms. The harms include intestinal perforation, bleeding, and death. European guidelines currently do not recommend colonoscopy screening. (If blood is found in the feces or a sigmoid exam is abnormal, then a colonoscopy may be indicated.)


Colonoscopy: the Gold Standard in the U.S.


According to an editorial in the June 15, 2016 JAMA Internal Medicine, "…there is no RCT (randomized clinical trial) (or other high-quality evidence) showing that colonoscopy reduces CRC mortality. In fact, the only tests shown to reduce CRC mortality in RCTs are periodic FOBT and a 1-time flexible sigmoidoscopy." The editorial concludes with this question: "It would be interesting to know how many patients would undergo colonoscopy if they knew that there were no data to suggest that this procedure results in longer life."


In the United States, colonoscopy is considered the gold standard and is, in practical terms, the only test offered. Patients are told, "they would be a fool not to get a colonoscopy." Harms from FOBT are none and those from flexible sigmoidoscopy are extremely rare. But you cannot get the correct endoscopy test, a flexible sigmoidoscopy, in the United States (with rare exceptions) because physicians in the U.S. have been brainwashed by the highly profitable colonoscopy industry, which includes gastroenterologists (physicians), clinics, hospitals, and device manufacturers.
It's the money. More than 10 million Americans get colonoscopies each year, with annual costs over $10 billion. The stool tests for blood are done at home and cost from $3 to $40. The cost of a sigmoidoscopy, which does not require sedation and is performed in a doctor's office in 20 minutes or less, is on average $200. A gastrointestinal specialist performs the colonoscopy, often in surgery centers and hospitals, under sedation, with an average cost of $3,081.


Newest 2016 USPSTF Guidelines: A Little of the Truth Exposed
The United States Preventive Services Task Force (USPSTF) 2016 guidelines strongly recommend screening for colorectal cancer. It lists seven different screening strategies (listed above), stating that "the screening tests are not presented in any preferred or ranked order," implying that the task force considers them to be equivalent. The USPSTF states, "To date, no CRC screening modality has been shown to reduce all-cause mortality. Robust data from well-conducted, population-based screening RCTs have demonstrated that both Hemoccult II (stool for blood) and SIG (sigmoidoscopy) can reduce CRC mortality, although neither of these tests is widely used for screening in the United States."


The USPSTF also notes, "Even though its superiority in a program of screening has not been empirically established, colonoscopy remains the criterion standard for assessing the test performance of other CRC screening tests. Moreover, colonoscopy is significantly more invasive than other available tests and thus carries a greater possibility of procedural complications, as well as harms of over-diagnosis and overtreatment of smaller lesions."


The USPSTF knows the truth. I read their muddled recommendations as a form of telling "the facts" in a way that still protects the $10 billion a year colonoscopy business.


McDougall's Recommendations


As with other common chronic diseases, such as coronary artery disease, diabetes, arthritis, and breast, prostate, and colon cancer, the importance of a healthy diet is universally overlooked. Not only for the prevention of these diseases, but also for their treatment. The reason is simply that there is no profit in recommending that people base their diets on beans, corn, potatoes, rice, and wheat, with some non-starchy fruits and vegetables; and avoid animal foods and vegetable oils. See Dr. McDougall's Color Picture Book on Food Poisoning.


Looking for problems (screening), and then treating them, is where all the money is made.
My stand for decades has been to recommend against screening for prostate cancer (PSA and digital rectal exams) and breast cancer (mammography and breast self-examination). Screening is the ultimate form of disease mongering: turning healthy people into patients. You can find my recommendations for screening for other kinds of cancer in my August 2014 Newsletter.

I do recommend conservative screening for colorectal cancer, because almost all of my patients have been following the Western diet for their entire life (until we met). I have recommended checking the stool for blood, beginning around age 60 years (testing every other year, at most, until age 75) and/or one sigmoid examination at around age 60 years. I have strongly recommended against colonoscopy for screening. Note that the recommendations I have been making for decades are almost the exact ones announced this year (2016) by The Canadian Task Force on Preventive Health Care.


Once a person is found to have polyps (of significant size: > 10 mm) and/or colon cancer, patients are advised to have a repeat colonoscopy every 1 to 10 years. This recommendation is based on speculation without convincing scientific support showing that this follow-up will improve a patient's quality or quantity of life. Unquestionably, however, every follow-up examination is accompanied by fear, anxiety, pain, inconvenience, loss of valuable time, life-threating complications, and/or increased risk of death on the examination table.

In summary, depend on your diet—not your doctor—to prevent death and suffering from colon cancer and other chronic diseases caused by food. You would be a fool to do otherwise.


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