Macrobiotics and Cancer Update

1. National Cancer Institute Approves Clinical Trials on Macrobiotic Approach

The U.S. government's National Cancer Institute (NCI) and Cancer Advisory Panel on Complementary and Alternative Medicine (CAPCAM) held a meeting on February 25, 2002 to review the Macrobiotic Best Case Series and unanimously recommended that research funds be made available for the further study of the macrobiotic approach to cancer, including possibly a prospective study. The recommendation followed completion of a best cases study by the University of Minnesota, which included 77 potential best cases of individuals who recovered from cancer with the help of macrobiotics.[i] These included cancers of the prostate (20 cases), breast (12 cases), malignant melanoma (8), lymphoma (8), leukemia (6), astrocytoma (5), colorectal (4), endometrium (3), ovary (3), pancreas (3), kidney (2), liver (1), small cell lung (1), multiple myeloma (1), nose plasmacytoma (1), parotic gland (1), sarcoma (1), and small intestine (1).


In his newsletter on cancer research, Dr. Ralph Moss, a cancer expert and member of the CAPCAM committee, explained:


The members of the panel have displayed an extraordinary degree of expertise in their respective fields. Some are top experts in cancer treatment, diagnostic radiology, tumor pathology and statistics. . . For the last few years, NCI has been asking alternative practitioners to submit their best cases for evaluation . . . yet surprisingly few alternative practitioners have taken up this challenge.


At this week's session, one group did. This was macrobiotics, presented by the Kushi Institute of Becket, Mass. Macrobiotics is more than a diet. It is a philosophical system based on the idea of achieving a balance . . .


The session brought forth strong testimony that sometimes the adoption of a macrobiotic diet is followed by the dramatic regression of advanced cancers. A nurse told how, in 1995, she was diagnosed with lung cancer that had spread all over her body. She received no effective conventional therapy, and reluctantly went on the macrobiotics diet . . . What makes this case so extraordinary is that her progress was monitored weekly by a sympathetic physician colleague. The shrinkage, and finally the disappearance, of her tumors was documented millimeter by millimeter! She has now been disease-free for over five years.

After this week's meeting I could definitely say there is real gold in macrobiotics. What is needed now is a serious clinical study in patients, using all the resources the NIH can muster. The Kushi Institute deserves credit for having taken these first steps toward documenting its methods and results. An influential government panel is at last listening.[ii]

2. Annals of Internal Medicine Study on Alternative Approaches to Cancer

In a review of current evidence on the efficacy and safety of selected complementary and alternative medical (CAM) therapies that are commonly used by patients with cancer, researchers at Harvard Medical School, the National Institutes of Health, and other institutions concluded in an article published in the Annals of Internal Medicine, "Several CAM therapies offer potential benefits for patients with cancer. Others, however, seem to be ineffective, and may present risks for direct adverse effects or interactions with conventional treatments. Therefore, it is important for physicians to communicate openly with patients about CAM use. Current evidence, although limited, suggests that physicians may reasonably accept some CAM therapies as adjuncts to conventional care and discourage others. As more data are gathered, the evidence-based recommendation of some CAM therapies and the evidence-based rejection of others will become more definite."


Reviewing "the opinions of respected authorities, based on clinical evidence, descriptive studies, or reports of expert committees," the researchers recommended that "it seems reasonable to accept macrobiotics as an adjunct to conventional treatment" for most types of cancer.[iii]


3. Italian Breast Cancer Study

In a random case control study involving 104 middle-aged women, Italian researchers reported that a macrobiotic diet could substantially reduce hormonal levels associated with higher risk of breast cancer.[iv] Known as the DIANA (Diet and Androgens) Trial, the study was conducted by the National Tumor Institute in Milan, funded by Cancer Program of the European Union, the Italian Association for Research on Cancer, and the CARLIPO Foundation, and published in Cancer Epidemiology, Biomarkers & Prevention, a major research journal in the United States.


The post-menopausal women were selected from a pool of volunteers living in the Milan area in north Italy who were at high risk for breast cancer on the basis of their hormonal and metabolic values. Half were assigned to the control group and half to the intervention group that received intensive dietary guidance and counseling and ate together twice a week over 4 1/2 months.


The researchers cited accumulating medical evidence that modern dietary habits, especially foods that contribute to hormonal imbalance, raise the risk of breast cancer, an epidemic disease that will afflict one in every eight women in America and Europe. Among Asian women who regularly consume soy products and other traditional foods, the rates of breast cancer are substantially lower than in Western women. However, the efficacy of dietary changes in reducing the availability of sex hormones in high risk women had not been sufficiently investigated.


The women in the study, aged 50 to 65 years, had testosterone levels that were two-thirds or more higher than average and hence put them at elevated risk for breast cancer. All had been postmenopausal for at least 2 years, had at least one ovary, had not taken hormonal replacement therapy for at least the previous 6 months, and were not diabetic. None of the women was following a vegetarian, macrobiotic, or other medically prescribed diet.


The 52 women in the control group were not given any information about the diet but were advised to increase their consumption of fruit and vegetables according to the cancer prevention guidelines of the Europe against Cancer program, a leaflet available to the general public. The 52 women in the intervention group attended macrobiotic cooking classes twice a week for 18 weeks and were encouraged to cook and eat macrobiotically at home, especially one soy product daily such as miso soup, tofu, or tempeh. Every week, the women received whole grains and other products donated by local natural foods manufacturers. During the first month, the women were advised to make dietary changes gradually, but later no advice was given to reduce total food intake or to count calories.


Prior to the trial, both groups of women received about 37% of calories from fat (mainly meat, dairy, and olive oil) and 42% from carbohydrate (bread and pasta). The intervention group shifted from animal to vegetable sources, reducing their meat consumption from daily to 1-2 times a week, dairy was halved, and butter virtually eliminated. Soy products were consumed on average 1.7 times daily and sea vegetables used every other day in various dishes. Brown rice or other whole grains were consumed 2.5 times per day compared to 0.5 times by controls, and consumption of legumes, cruciferous vegetables, and berries were four to eight times higher. Other vegetables and fruits were consumed about equally by both groups.


Total cholesterol decreased from 240 to 206 mg/dl compared to 230 in the control group. The intervention group lost more weight, 4.06 kg compared to 0.54 kg, and underwent statistically significant improvements in the five major hormonal and metabolic values combined: sex hormone-binding globulin, testosterone, estradiol, fasting insulin, and fasting glycemia. Serum sex hormone-binding globulin levels increased 25.2%, testosterone and estradiol decreased 19.5% and 18% respectively.


"We observed significant and favorable changes in hormonal indicators of breast cancer risk in a group of postmenopausal women living in northern Italy," the researchers concluded. "These results suggest that the multifactorial dietary intervention applied in this study may prevent breast cancer if continued in the long term." "Compared with the usual Western microflora, the gut of macrobiotic or vegetarian subjects may be richer in lactobacilli and bifidobacteria," the scientists further noted.


Compared to previous studies that involved a single factor, the DIANA trial involved a multifactorial approach that produced stronger results. "We suggest that these favorable changes are to be attributed to the cumulative effects of a comprehensive dietary strategy that combines lowered total fat intake, lowered proportion of saturated fatty acids, and lowered consumption of high-glycemic-index foods with increased intake of dietary fibers from cereals, legumes, and vegetables, and a high cumulative dose of diverse phytoestrogens from various food sources."

4. Study on Macrobiotics by the University of South Carolina
In a two-year grant sponsored by the Centers for Disease Control and Disease Prevention, the public health arm of the United States, cancer researchers at the School of Public Health, University of South Carolina, investigated the macrobiotic way of life. In a report "Macrobiotics in the United States: An Assessment of Services and Activities," Sheldon and Guinat Rice interviewed 124 practitioners in 44 locales. Fifty-one people recounted personal healing stories in which macrobiotic practice reversed a serious health condition. Of these, twenty one were instances of cancer and four more were pre-cancerous cysts. The researchers posted a selection of recovery stories from cancer and other chronic diseases on the Internet along with a list of macrobiotic resources, including educational centers, teachers and counselors, and books and other study materials for the use of the general public.[v]

5. M.D. Anderson Cancer Center, University of Texas, Houston Scientific Review of Macrobiotics

Cancer researchers at M.D. Anderson Cancer Center at the University of Texas in Houston posted a historical overview of macrobiotics as a therapy for cancer patients and the general public on their web site in early 2003. "The macrobiotic diet is part of a way of life that attempts to achieve balance by applying the oriental principles of yin and yang to the selection of foods. Grains and vegetables are considered to be the ideal center of a diet that also includes beans, fish, fowl, fruits, seeds, nuts and condiments. Whole no foods are actually forbidden, some may be limited in a therapeutic context." The site reviews the Office of Technology Assessment (OTA) study that found macrobiotics to be among the most popular unconventional cancer approaches; the study of the macrobiotic approach to pancreatic cancer at Tulane University; a review of the book Cancer Free: 30 Who Triumphed Over Cancer Naturally, including prostate cancer (3 cases), melanoma (6), uterus (3), breast (5), stomach, leukemia, and pancreas (2 each), colon (2), astrocytoma, urethra, lung, brain, thyroid, leukemia (CML), bile duct, Hodgkin's disease, and ovarian (1 each); a best case series of 6 medically-documented cases: pancreatic metastasized to the liver, malignant melanoma; malignant astrocyoma, endometrial stromal sarcoma; adenocarcinoma of the colon, and abdominal leiomyosarcoma; and other retrospective cohort studies, best case series, and case reports.[vi] According to one study, 63% of cancer patients who received some form of dietary therapy received or were exposed to the macrobiotic diet.


[I] "Macrobiotic Approach to Cancer," grant number R21RR09472, by the Office of Alternative Medicine, National Institutes of Health, 1993-1997 to the University of Minnesota Twin Cities and the Kushi Institute, Lawrence H. Kushi, principal investigator. For further information, see www.nccam.


[II] Ralph Moss, Ph.D., "The Olive Branch Bears Fruit," The Moss Reports, February 27, 2002.


[III] Wendy A. Weiger, M.D. et al., "Advising patients Who Seek Complementary and Alternative Medical Therpaies for Cancer," Annals of Internal Medicine 137:11, 2002.


[IV] Franco Berrino et al., "Reducing Bioavailable Sex Hormones through a Comprehensive Change in Diet: the Diet and Androgens (DIANA) Randomized Trial," Cancer Epidemiology, Biomarkers, & Prevention 10: 25-33, January 2001.


[V] "Macrobiotic Research Project," Jane Teas, Ph.D., principal investigator; Joan Cunningham, Ph.D., co-principal investigator, sponsored by the Centers for Disease Control, October 2000 to September 2002, University of South Carolina, Prevention Research Center, School of Public Health, Charleston, S.C.


[VI] "Nutrition and Special Diet: Macrobiotics," M.D. Anderson Cancer Center, the University of Texas,