Tag Archives: turmeric

On The Case: Methionine & Cancer Part III

Before launching into more shocking truths about methionine, I want to share a story told by Chef Ryan Callahan in the August issue of Conquer magazine. Chef Ryan’s best friend, Tommy, was diagnosed with stage 4 liver cancer at 21 years old and died just 2 months later. Chef Ryan writes that Tommy had a 4th-degree black belt in Taekwondo and a healthy lifestyle overall. However, once Tommy began an aggressive course of chemo, he could only manage to eat salty junk foods and cookies.

Chef Ryan believes that if he’d understood and been able to teach Tommy’s family cooking techniques for countering chemo’s eating-related side effects, Tommy would not have died so soon.

Tommy’s story does make me curious about the role of Registered Dietitians during the course of his treatment – an RD should have assessed Tommy’s nutritional status and counseled him and his family about all the available options. But whatever the case may have been, this tragic story highlights the critical yet all-too-often ignored component of fighting cancer:

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Nowadays, patients and their families do have great resources. Chef Ryan was inspired to write a cookbook and offers tips and how-to videos. A reader also recently reminded me about Rebecca Katz,

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Rebecca Katz wearing a zucchini noodle necklace

whose cancer-fighting food workshop I attended years ago as a dietetic grad student in Seattle. Rebecca has authored several cookbooks and released the Cancer Fighting Kitchen online course last month.

I’ve resolved to delve deeper into the material these two have developed as I continue to work on my cooking skills. Speaking of which, this weekend my fiance and I collaborated on making hamburger patties. We got a pound of grass-fed ground beef and mixed it with 1 pasture-raised egg, 2 cloves of minced garlic and a ½ teaspoon of turmeric along with salt & pepper.

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My fiance’s turmeric burger – I had mine sans bun alongside veggies

This was enough for three patties, and I had the leftovers for my Sunday lunch. We both enjoyed the beef but couldn’t really taste the turmeric, which was fine by my fiance. Still, the next time we make burgers, I might use a whole teaspoon of turmeric. If my fiance objects, I can up the seasoning on my portion only.

I’m leading this post with tales of my kitchen experiments in order to emphasize that the scientific literature on methionine restriction has not swayed me to cut out meat or otherwise alter my diet. As I’ve concluded in my previous post, far too much is still uncertain and the changes required would be maddeningly complicated at best – dangerous at worst.

Even if I could follow an ultra-low-methionine diet without jeopardizing my physical and mental health, the anticancer effect would not be assured. After all, researchers documented numerous cancer cell lines that were only slightly or not at all dependent on methionine. As far back as 16 years ago, an article in Cancer Research called for the development of a genetic test to identify methionine-dependent tumors in order to incorporate that information into efficacy studies for methionine-lowering treatments.

So where was this genetic test? Where were those efficacy clinical trials? Why did this promising research seemingly stall after Dr. Epner et al. published findings from a Phase I trial in 2002?

Google told me that Daniel Epner, M.D., was a Professor at The University of Texas MD bitmoji1174324671Anderson Cancer Center in Houston, TX. I reached out to Dr. Epner via email  to ask him why he left the field of methionine restriction research. To my surprise, he actually responded:

Marina,

I am sorry to learn about your cancer diagnosis. I wish you the very best in your treatment.

I led a basic science program for about 10 years at the beginning of my career during which I focused on abnormal nutrient metabolism as a potential target for cancer treatment. One of my main interests was methionine metabolism, since animal studies showed that dietary and or enzymatic methionine deprivation had anti-tumor activity. Methionine plays a key role in methylation of nucleic acids and proteins and is a key precursor for polyamines, both highly relevant to tumor growth.

We had support from Abbott laboratories for the phase I trial you mentioned in your email. In addition, Abbot supported a second clinical trial on which I collaborated with an investigator at MD Anderson (when I was still on the faculty at Baylor College of Medicine, before I moved to MD Anderson 8 years ago). That trial involved combining the experimental diet with chemotherapy for patients with primary brain tumors. However, my collaborator was unable to enroll a sufficient number of patients on that trial for reasons that were never clear to me. Perhaps his colleagues did not have faith in the strategy or perhaps patients were not enthusiastic about adhering to a strict dietary regime. Over time, Abbott became less enthusiastic about supporting the methionine restriction work since they did not think dietary methionine restriction would be commercially viable. 

Coincidentally at around that time, my career interests naturally evolved. I became very interested in psychosocial aspects of oncology, and I came to appreciate the power of relationships between doctors and their patients and families. This career evolution led to my interest and involvement in teaching communication skills and writing about relational aspects of oncology. Over time, my colleagues and I at MD Anderson decided I should transition to the department of Palliative Medicine, where I now reside, after having practiced medical oncology for about 20 years.  My main academic focus is now communication skills training and narrative medicine.   I still think methionine restriction is potentially viable as cancer treatment, but I have not actually worked in the field for many years. I know that Robert Hoffman PhD at Anticancer Inc. in San Diego has developed methioninase, the methionine degrading enzyme, as cancer treatment, but I do not know where that work stands now. You may want to contact him for an update and read his recent publications.

I still believe methionine deprivation is a very promising strategy from the purely scientific standpoint if you put aside marketing and other considerations. Nonetheless, I would strongly advise against anyone with cancer pursuing a methionine restricted diet outside of a clinical trial approved by an institutional IRB, just as I would advise against anyone receiving any form of experimental therapy outside of a clinical trial.

My thoughts and prayers are with you as you battle cancer.  I hope this information is helpful.

Best Regards,
Daniel E. Epner, MD, FACP

I appreciated his thoughtful reply. He confirmed my suspicion that funding was one of the barriers to moving forward with clinical trials, but also gave me a fuller picture of some of the other factors at play.

I do wonder why the follow-up clinical trial that Dr. Epner and his collaborator attempted had to focus specifically on brain cancer rather than, say, breast cancer or all metastatic cancers for that matter. But it’s usually not productive to ruminate about the past.ryanlerch-warning-cows-roadsign-2400px Besides, Dr. Epner had given me another lead to follow: Dr. Robert Hoffman. Searching for his work led me to AntiCancer, Incorporated. This company has a patent for and sells L-Methionine-g-lyase (METase), an enzyme that degrades methionine. genious-emoji

So there’s no need to follow a complicated diet, methioninase can do the job of breaking down methionine before tumor cells have a chance to feed on it, right? If that’s the case,  where are the clinical trials? Why aren’t researchers jumping on the chance to test this potentially life-saving treatment?

I emailed the company’s COO, Charlene Cooper, to find out if any human studies with methioninase were planned. I’ll share her reply, and more about methionine degrading enzymes as a treatment option for cancer, in my next post.
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Should I Go Vegan to Fight Breast Cancer?

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I’m researching and writing this series of posts with a bias. For nearly eight years, I’ve eaten a mostly Paleo or Primal diet.

A common misconception about the Paleo diet is that it’s very meat-heavy. That may be true for some Paleo enthusiasts, but the bloggers and podcasters that I follow have always emphasized eating plenty of fruits and veggies, choosing high-quality whole (non-processed or minimally-processed) foods with the highest nutrient density, and self-experimentation to personalize the diet to each individual situation.

Over the past several years, the Paleo diet has begun to morph into a lifestyle, with advocates emphasizing the importance of stress management, moving/staying active, getting enough quality sleep and even maintaining good social connections.

For me, going Paleo wasn’t so much about going gluten-free or loading up on meat as it was about giving up highly processed food that I felt nearly addicted to. EatingIceCreamCupcake

Fruit replaced cookies and bagels got switched out for pumpkin seeds and almonds. Hamburger buns became mushroom buns. That meant that my fruit and vegetable intake skyrocketed, while my meat consumption actually decreased.

I also became aware of the health benefits of choosing wild-caught salmon, grass-fed beef and eggs from pasture-raised chickens. Being so choosy comes at a high cost. As a graduate student and later an AmeriCorps VISTA volunteer, I could only afford to have grass-fed beef or wild-caught salmon as an occasional treat. My main sources of protein were eggs from pastured chickens, sardines and sometimes cheese or yogurt.

I considered my eating habits to be predominantly pescatarian, and started to use the terms nutritarian (or nutrivore? Best terminology TBD) to describe the philosophy behind my dietary choices.

On many occasions my nutritarian aspirations were restricted by cost, cooking skills or taste buds. Still, I thought I was doing pretty well.HealthyLivingEmojiAnd then I was diagnosed with stage 4 breast cancer.

I felt like the universe was playing a joke on me. As a Registered Dietitian, I counseled people on making healthy food and lifestyle choices. How ironic that practicing what I preached failed to protect me.

Who knows, though – maybe I could have avoided cancer if I’d changed my eating habits as a teen. Or maybe something about my Paleo-ish diet did contribute to the cancer’s development. Not enough organic produce? Too much cheese? Too much animal protein? Too much kale?

Numerous studies do show an association between meat intake and cancer. However, in her evidence-based analysis of this link between meat and cancer, Sarah Ballantyne, Ph.D., concludes that: yes meat does

Dr. Ballantyne’s point-by-point examination of the cancer-promoting substances in meat and how they can be neutralized by plant foods, especially cruciferous vegetables, helped me to not be overly swayed by stories like Kris Carr’s.

Kris was diagnosed with a very rare form of cancer (40-80 cases per year in the U.S.) called epithelioid hemangioendothelioma in 2003. She went on to direct the documentary Crazy Sexy Cancer and to author several New York Times best-seller vegan cookbooks.

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Kris’s story is, indeed, crazy sexy inspirational. She was able to use a devastating diagnosis of stage 4 cancer as a catalyst for improving her life. Most intriguing of all, her cancer appears to have been stable for over thirteen years and counting! Would I see the same crazy sexy results if I became a vegan like her?too sexy emoji

Another blogger, Dr. Elaine Schattner, offers a medical perspective on how Kris Carr has been able to thrive with cancer for so long. Epithelioid hemangioendothelioma (EH) comes in two forms – one that’s aggressive and another that isn’t. Kris luckily has the latter, non-aggressive form of EH. She’s been able to stay in wait-and-watch mode since receiving her diagnosis, and has never had chemo, radiation or major surgery to treat her cancer.

It’s entirely possible that Kris’s diet has helped to keep her cancer at bay. But Dr. Schattner’s post convinced me that Kris’s current well-being is due in large part to the type of cancer she has rather than any particular diet she might be following.

It’s also impossible to tell whether the vegan aspect of Kris’s diet is necessary. The results she sees could be entirely due to her shift from junk food to whole, minimally-processed food that includes a wide variety of fruits and veggies. Foregoing meat may have nothing to do with her or her followers’ success on the diet.

Or so I thought, until a friend emailed me a link to an article about methionine.

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More (much more) about that in my next post.

For now, I’ll leave you with a pic of the latest turmeric dish made by yours truly, with a bit of assistance from my patient fiance:

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Inspired by this post’s topic, I followed the Superfood Veggie Soup recipe from my Turmeric Pinterest board, with some modifications. I didn’t include carrots since I only like them raw, but I upped the garlic to five cloves, threw in some bay leaves and added an extra teaspoon of turmeric. My frozen veggies were okra and mixed mushrooms, and I substituted kale for Nori.

I made the stew for dinner a few nights ago but found it even more delicious when I heated it up for lunch the next day. I couldn’t taste the turmeric so threw in another tablespoon for the whole pot of leftovers. I think it’s just right at two tablespoons of turmeric for the entire pot, though the recipe only calls for two teaspoons.

The stew is all gone now, the turmeric-stained ladle licked clean. I’m thinking of making it again next week. Any suggestions for what veggies I can add to complement the mushrooms, kale, okra, tomatoes, garlic and onions?

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How Can I Motivate Myself to Eat More Turmeric?

I didn’t plan on writing another post on turmeric. But after getting some tips via facebook in response to my previous post, I thought I’d put up a quick update.

Jessica of Our Little Honey Bun shared a turmeric milk recipe with me involving honey and a cardamom pod – sounds delicious! And then one of my favorite teachers from high school, Dr. N of Dr N’s Blog told me about putting fresh turmeric root in smoothies with black pepper, coconut oil, and lots of fresh fruits & veggies. These, and a few other comments, inspired me to start collecting turmeric recipes on pinterest.

So far, I’ve pinned more than 40 recipes that incorporate turmeric.

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Some are desserts that I’d only make for special occasions, or tempting drinks with a per-cup sugar load that gets my spidey sense tingling. Others are savory dishes and veggie-filled soups that I’d like to try soon. The mouthwatering photos accompanying the recipes certainly motivate me to get in the kitchen.

I’ve never been much of cook, though. I aced my food science and food safety classes in grad school, but food prep has always appealed more in theory than in fact. I can boil and scramble eggs, make salads and stews, cover strawberries in chocolate, and even bake the (very) occasional cake. Yet other than boiling eggs, none of these are daily occurrences.

So the aspirational pinterest photos aren’t motivating enough, on their own, to get me to attempt a turmeric recipe. That’s where science comes in. I found a few studies specifically about using turmeric in cooking. A recent article published last spring in the International Journal of Food Sciences and Nutrition has a title that basically says it all: “Turmeric and black pepper spices decrease lipid peroxidation in meat patties during cooking.” Lipid peroxidation happens when free radicals react with lipids. Studies show that eating food with lipid peroxidation products poses health risks, and is associated with diseases such as atherosclerosis, cancer and myopathy.

This suggests that not only would I be getting the anti-cancer benefits of turmeric if I used it in cooking alongside black pepper, but I’d help to protect my food from health-damaging free radical damage to boot.

Food scientists also found that turmeric powder added to burgers at 3.5 grams per 100 grams of meat acted as a natural antioxidant, “increasing the quality and extending the shelf life of rabbit burgers.”

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I’m not sure why these scientists, who happen to be based in Italy and Hungary, were specifically interested in rabbit burgers. I have no plans to make rabbit burgers in the foreseeable future, but I’d assume that this study’s findings can apply to many types of meat and perhaps vegetarian dishes as well.

An earlier study with turmeric and fish lends support to this idea. Fish contain a high percentage of polyunsaturated fatty acids (PUFAs). That’s usually considered a good thing, but the high degree of PUFA unsaturation means that they are more vulnerable to oxidation by free radicals than other types of fatty acids. But, good news for fish lovers: researchers found that 75 mg of powdered turmeric root significantly inhibited lipid peroxidation in cooked mackerel.

These studies convince me that supplements, even if they do contain turmeric/curcumin in the amounts claimed on the labels, can’t offer me the full benefits that cooking with freshly ground turmeric root would. But I’m not ready to ditch the supplements, because I can’t see how I would ever get up to eating or drinking 3-4 grams of the spice each day. It has a distinct taste, which I don’t like except as a faint note in the background of louder flavors.

I decide to start slowly; I can keep my supplement regimen while experimenting with the turmeric recipes I’ve saved on my pinterest boards.

Just one recipe each week – that sounds like a reasonable goal.

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And this blog is a handy tool to keep me accountable. Stay tuned to find out about my turmeric kitchen adventures.

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Dose & Type of Turmeric Supplement – What’s the Best Choice?

Note: this is my third in a series of posts about turmeric. To get the full story on why I decided to take the supplement and possible contraindications to supplementing, please see my first and second posts.


I’d intended to get this post up earlier, but my current chemo regimen makes me prone to long naps on the couch.naptime emoji

Though truth be told, this post was also harder for me to write. I’m still figuring out the dosing and which brand of supplement I should go with. I’ll share what I learned from my research, and perhaps you, dear readers, can make suggestions or tell me about your own experiences with different brands.

Once I made the decision to take a turmeric supplement, I looked to see what was available on Amazon. Pages and pages of options came up – I clicked through more than ten before realizing that I needed more pubmed.gov research time.     

I learned three main points:

1) Turmeric as a whole spice works better than isolated curcumin.

A study comparing turmeric to curcumin found:

…in breast cancer cells curcumin induced 33% growth inhibition, while 66% growth inhibition was observed by turmeric containing equivalent amount of curcumin. A similar trend was observed with other tumor cells. These observations indicate that components other than curcumin might contribute to the potency of turmeric. (emphasis mine)

Not surprising if you consider that turmeric has more than 300 components in total, though curcumin has been the one most thoroughly studied. A review article provides a good graphic of the most  promising compounds found in turmeric besides curcumin:

Noncurcumin_Compounds of turmeric

Some of these compounds, including turmerones, elemene, furanodiene, cyclocurcumin, calebin A and germacrone have inhibited growth or induced apoptosis (cell death) in many different types of human cancer cells.

I also found an article published late last year describing yet another turmeric-derived compound, β-sesquiphellandrene (SQP). The authors found SQP to be highly effective in suppressing cancer cell colony formation and inducing apoptosis. SQP is also synergistic with the chemotherapeutic agents velcade, thalidomide and capecitabine (Xeloda, the chemo regimen that I’m on right now!)

So I’d be missing out on all that synergy if I took a supplement containing curcumin alone.

Supplement FactsThe supplement with is label wouldn’t do, since it only contains 25mg of all the other compounds besides curcumin.

Instead, I was looking for ingredients like:

organic turmeric supplement facts
According to the label above, there’s about 95mg of curcumin per two capsules, but also 900mg of turmeric spice with its full spectrum of beneficial compounds. The 10mg of black pepper claimed on the label is also a plus.

Which brings me to my second point – another aspect of turmeric that challenges researchers:

2) Turmeric is not water-soluble and our bodies have trouble absorbing it. Fats and piperine from black pepper help make turmeric more bioavailable.

This insight allowed me to eliminate supplements that did not contain that black pepper extract. While there are also a few supplements on the market that package the turmeric and black pepper alongside oils to further improve bioavailability, I planned to take capsules with meals. I’m hoping that fats from the eggs I have for breakfast or the fish I have for dinner are enough to help at least some of the turmeric be absorbed.

I was still worried, however, that I wouldn’t be getting enough turmeric or curcumin to really make a difference with my tumors. Studies in humans showed that a curcumin dose as low as 1.8 grams per day produced a “measurable pharmacodynamic change,” but what does that actually mean? It’s unclear how much of the curcumin was actually absorbed into tissues. Other studies used doses of 4 – 8 g — it’s been administered safely at up to 12 g daily over 3 months in clinical trials.

I decided to aim for 3 – 4 grams per day to start with. Since most supplements have about 1 g of turmeric/curcumin per serving (which can be two or three capsules), I’d need to take capsules with every meal and maybe sometimes with snacks. That gets expensive!

Worse, such a regimen won’t necessarily ensure that I ingest those promised 3 – 4 grams. It’s a leap of faith on my part, since supplements are not reviewed by the FDA before they go to market. Third-party verification is, unfortunately, not widespread in the turmeric supplement industry, so I have little choice but to believe the bottle labels. Even the brands claiming organic turmeric don’t seem to have third-party verification to back up those statements.

But I could hedge my bets by taking capsules from a few different brands. The third major thing I learned about turmeric/curcumin:

3) Researchers are formulating more bioavailable forms of curcumin.

One such preparation, dubbed Theracurmin, achieved dramatically higher absorption rates in mice and humans by disbursing curcumin with colloidal nano-particles. I’ve come across other formulations using nano-particles, but Theracurmin was the only one I could find on Amazon.

I ended up ordering the Theracurmin and another supplement that included turmeric as well as curcumin. I also got a bottle of turmeric capsules from my local Whole Foods. Between the three, I might be getting something close to the intended dose. It adds up to a lot of money, but I feel like I have to give this experiment my best shot.  All In Emoji

I’ll have no idea what the supplements are doing, if anything, till I get scans and tests after this third cycle of chemo. I’ll post updates once I get those results.

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