Breast Cancer Survival Vegetable

Breast Cancer Survival Vegetable
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Simple changes in diet and lifestyle may quadruple a woman’s survival rate from breast cancer.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

A half-million Americans are expected to die this year from cancer—equal to five jumbo jets crashing, every day. “The number of Americans who die from cancer each year is more than all those who have died in all US wars combined.” And, this happens every single year.

After a cancer diagnosis, people tend to clean up their diets. About a third to a half of breast cancer patients, for example, make healthy dietary changes following diagnosis—such as increasing fruit and vegetable consumption, and decreasing meat, fat, and sugar intakes. Does this actually help, that late in the game? Well, “the Women’s Healthy Eating and Living [WHEL] Study was undertaken in [a few thousand] breast cancer survivors to determine if a plant-based, low-fat, high-fiber diet could influence breast cancer recurrence rates and survival.”

Previously, they famously reported that simple changes—five or more servings of fruits and veggies a day, and just, like, walking thirty minutes a day, six days a week, was associated with a significant survival advantage—cutting risk nearly in half. Note; I said fruits and veggies and exercise. Here’s the proportion of women with breast cancer surviving nine years in the study, if they had low fruit and vegetable consumption, and low physical activity—or, high in one, and low in the other. But, here’s the survival curve of those high in both.

And, it worked just as well in women with estrogen receptor negative tumors, which normally have twice the mortality—unless, you eat a few fruits and veggies, and take a few strolls. The High should really be in quotes. I mean, you could eat five servings in a single meal, and certainly walk more than, like, two miles a day.

Imagine, for a second, you have been diagnosed with breast cancer. Imagine sitting in that chair, in the doctor’s office, as your doctor gives you the news. But, there’s a new experimental treatment that can cut your chances of dying in the next few years from, like, 16% down to just 4%. To quadruple their survival rate, many women would remortgage their homes to fly to some quack clinic in Mexico, would lose all their hair to chemo, but most, apparently, couldn’t stand the thought of eating broccoli.

And, indeed, that’s what the latest report from the Women’s Healthy Eating and Living Study found. Fruits and vegetables may be good, but cruciferous vegetables may be better. For women on tamoxifen, for example, if one of their five daily servings of fruits and veggies was broccoli or cauliflower, collards, cabbage, or kale, the risk of cancer recurrence may be cut in half.

Please consider volunteering to help out on the site.

Images thanks to the National Cancer Institute and the U.S. Navy via Wikimedia

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

A half-million Americans are expected to die this year from cancer—equal to five jumbo jets crashing, every day. “The number of Americans who die from cancer each year is more than all those who have died in all US wars combined.” And, this happens every single year.

After a cancer diagnosis, people tend to clean up their diets. About a third to a half of breast cancer patients, for example, make healthy dietary changes following diagnosis—such as increasing fruit and vegetable consumption, and decreasing meat, fat, and sugar intakes. Does this actually help, that late in the game? Well, “the Women’s Healthy Eating and Living [WHEL] Study was undertaken in [a few thousand] breast cancer survivors to determine if a plant-based, low-fat, high-fiber diet could influence breast cancer recurrence rates and survival.”

Previously, they famously reported that simple changes—five or more servings of fruits and veggies a day, and just, like, walking thirty minutes a day, six days a week, was associated with a significant survival advantage—cutting risk nearly in half. Note; I said fruits and veggies and exercise. Here’s the proportion of women with breast cancer surviving nine years in the study, if they had low fruit and vegetable consumption, and low physical activity—or, high in one, and low in the other. But, here’s the survival curve of those high in both.

And, it worked just as well in women with estrogen receptor negative tumors, which normally have twice the mortality—unless, you eat a few fruits and veggies, and take a few strolls. The High should really be in quotes. I mean, you could eat five servings in a single meal, and certainly walk more than, like, two miles a day.

Imagine, for a second, you have been diagnosed with breast cancer. Imagine sitting in that chair, in the doctor’s office, as your doctor gives you the news. But, there’s a new experimental treatment that can cut your chances of dying in the next few years from, like, 16% down to just 4%. To quadruple their survival rate, many women would remortgage their homes to fly to some quack clinic in Mexico, would lose all their hair to chemo, but most, apparently, couldn’t stand the thought of eating broccoli.

And, indeed, that’s what the latest report from the Women’s Healthy Eating and Living Study found. Fruits and vegetables may be good, but cruciferous vegetables may be better. For women on tamoxifen, for example, if one of their five daily servings of fruits and veggies was broccoli or cauliflower, collards, cabbage, or kale, the risk of cancer recurrence may be cut in half.

Please consider volunteering to help out on the site.

Images thanks to the National Cancer Institute and the U.S. Navy via Wikimedia

Doctor's Note

I recommend that all women with breast cancer eat broccoli sprouts. See my eight-part video series:

  1. DNA Protection from Broccoli
  2. Sulforaphane: From Broccoli to Breast
  3. Broccoli vs. Breast Cancer Stem Cells
  4. Liver Toxicity Due to Broccoli Juice?
  5. How Much Broccoli Is Too Much?
  6. The Best Detox
  7. Sometimes the Enzyme Myth Is True
  8. Biggest Nutrition Bang for your Buck

They may also help out with other cancers (see Lung Cancer Metastases & Broccoli and Raw Broccoli & Bladder Cancer Survival).

For more on breast cancer survival, see:

And, even better, preventing it in the first place! Here are ten more, and you can check out dozens more of my other videos on breast cancer:

Some of this video may sound familiar—I included it in my 2013 live presentation, More than an Apple a Day: Combating Common Diseases.

For further context, check out my associated blog post: Quadrupling Breast Cancer Survival.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

65 responses to “Breast Cancer Survival Vegetable

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  1. The bar plot flashed at around 1:37 minutes through the video seems to show a much greater effect of high fruit and vegetable consumption or physical activity on reducing the mortality of patients who have estrogen-receptor negative breast tumours.
    Can anyone provide insights on why that might be the case?




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    1. Hi VegAtHeart,
      Thanks for your thoughtful question. Based on the study mentioned at 1:37 minutes, risk of death (mortality) for women who follow a plant-based diet is similar (~3-4%) whether or not the breast cancer expresses the genes for estrogen receptivity. I am not sure, but I suspect that the reason for the relatively larger overall decrease in mortality in the estrogen-negative (ER-) receptor breast cancer is that ER- cancer may be less sensitive to circulating estrogen and more sensitive to the hormone IGF-1, which is triggered (or not) by the food we eat. Check out Dr. Greger’s video about this for more details:
      http://nutritionfacts.org/video/igf-1-as-one-stop-cancer-shop/
      I hope this helps. Love your pic, btw :)




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      1. Thanks for your positive response. It is interesting how you look at this from an IGF-1 perspective. It seems that one of the challenges in interpreting research on whole foods is that there are so many possible mechanisms that could simultaneously be at work.




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    2. The unedited figure can be found as figure 3 Pierce et al, 2007. The ER-/PR- cancers demonstrated a better prognosis than ER+/PR- or ER-/PR+, not the expectation, so we may be seeing small sample size effects.

      Given only 75 patients had the ER-/PR+ tumor receptor status highlighted in the video, just one or two deaths (or their absence) would have changed the mortality (%) quite a bit. You’ll note that the four-fold larger (and hence more statistically reliable) cohort of ER-/PR- patients demonstrated an improvement from veggies and exercise, but less than the improvement seen in ER+/PR+ cases. This makes intuitive sense, too, given the importance of phytoestrogens in modulating estrogen & progesterone signalling.




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      1. Thanks for pointing out the limitation of sample size.

        I am trying to understand your argument concerning phytoestrogenic modulation…Are you saying that the relatively higher quantity of phytoestrogens in the high fruit and vegetable group might diminish the negative effect of a person being ER+/PR+, which would in turn provide a relative reduction in mortality?




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        1. ER+ and PR+ tumors express receptors to normally occurring hormones for breast tissue growth, and this provides the therapeutic options of silencing that growth signalling with tamoxifen and aromatase inhibitors. The availabilty of these therapies have dramatically lowered mortality for ER+ and PR+ breast cancers, while outcomes with ER-/PR- and triple negative cancers haven’t improved as much.

          Common phytoestrogens like flax lignans and soy isoflavones bind estrogen receptors, and while there competitively block binding of native estrogen; but they don’t have quite the right shape to efficiently change the receptor conformation and send signals downstream. I visualize them as rubber keys: they can enter a lock (their receptor), perhaps turn it better than no key at all, but overall they largely block the effects of the correct brass keys, which can’t enter while the rubber key is stuck.

          So, diets high in fruits, vegetables and phytoestrogens like those in flax, soy and other vegetables can be expected to have a tamoxifen-like effect on ER+ cancers, in addition to their non-phytoestrogen effects. With ER- tumors, only the non-phytoestrogen effects of high fruit-vegetable diets would appear. This suggests to me that we might expect a larger reduction in mortality from high fruit & vegetable diets in ER+ tumors than in ER- tumors.

          In the study that was the case in comparing the two largest cohorts (ER+/PR+ vs. ER-/PR-), but wasn’t the case comparing ER+/PR+ with the smaller ER-/PR+ and ER+/PR- cohorts.




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          1. Thank you so much for taking the time to answer; I think that this is an outstanding answer and really helps me appreciate the effects of phytoestrogens.




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            1. I came across a review that clarified my understanding of estrogen receptors, and owe you a revision to my explanation:

              There are (at least) two types of estrogen receptor, an alpha receptor responsible for both the feminizing effects of estrogen and promotion of breast and uterine cancers, and a beta receptor without feminizing effects that appears to suppress cancers of the breast, prostate and colon. Soy isoflavones in dietary amounts selectively activates the beta receptor (and hence one can eat soy without feminizing effects), but in a few animal studies, very high (non-dietary) doses of soy isoflavones can also activate alpha receptors. Another case of whole-plant food good, pill extract bad.




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              1. Thank you for this information. That is extremely interesting and an excellent point to use to defend against some of the false claims we hear regarding soy and estrogen.
                Would you mind making the source of the review available (even citation would do)?




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                  1. Thanks again. I was trying to make sense of Table 2 from the Endocrinology paper and found this article which provides a breakdown of the specific phytoestrogen components in foods. I don’t know why the USDA data tables do not seem to provide food content of phytoestrogens, since they have gone to the trouble for micronutrients such as lycopene.




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                  2. Could you help us read Table 2 in the Kuiper study?

                    Genistein’s binding affinity for ERalpha is 87; for ER beta .7. So why do you say that it has a greater affinity for the beta receptor? Is it because when genistein binds to ER alpha, it turns off any actions ERalpha may trigger?




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                    1. The formatting is off in the html version. In the pdf version, there are two experiments to determine relative binding affinity, in solid phase and in solution, with the binding affinity of the endogenous ligand estradiol arbitrarily defined as 100.

                      solid phase solution
                      ERα ERβ ERα ERβ
                      estradiol 100 100 100 100
                      genistein 4 87 0.7 13




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              2. This guy wasn’t taking an extract, he was EATING soy.

                Endocr Pract. 2008 May-Jun;14(4):415-8.

                An unusual case of gynecomastia associated with soy product consumption.

                OBJECTIVE: To document a case of gynecomastia related to ingestion of soy products and review the literature.

                METHODS: We present the clinical course of a man with gynecomastia in relation to ingestion of 2 different soy products and review related literature.

                RESULTS: A 60-year-old man was referred to the endocrinology clinic for evaluation of bilateral gynecomastia of 6 months’ duration. He reported erectile dysfunction and decreased libido. On further review of systems, he reported no changes in testicular size, no history of testicular trauma, no sexually transmitted diseases, no headaches, no visual changes, and no change in muscular mass or strength. Initial laboratory assessment showed estrone and estradiol concentrations to be 4-fold increased above the upper limit of the reference range and he described a daily intake of 3 quarts of soy milk. After he discontinued drinking soy milk, his breast tenderness resolved and his estradiol concentration slowly returned to normal.




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                    1. 100 grams of whole, steamed edamame contains almost 19 grams of isoflavones. Firm tofu contains 23 grams per 100 grams serving. Soy milk contains 2.5 grams per 100 gram serving. In other words, WHOLE soy sources are MUCH higher in isoflavones. An 8 oz cup of steamed edamame contains almost 45 grams of isoflavones. A cup of soymilk only contains 7.5.
                      3 quarts (the amount consumed in the study) contains about 90 grams of isoflavones. So don’t suggest that the soy-milk consumption is an exceptionally excessive intake of soy, when 2 cups of whole food soy equals the very same level of isoflavones- and it isn’t unusual for a whole food vegan to eat that much soy.
                      And even if you don’t eat THAT MUCH, clearly, if two cups can cause man-boobs, it’s having a significant overriding effect on a man’s testosterone. This means that even smaller quantities effect natural androgen levels.




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                  1. Just a quick question. Was the issue of other estrogen raising products out of his diet that might be enhancing this breast tissue growth. In Australia we have some research on alcohol and it enhancing gynecomastia.




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                1. Dietary lignans are converted by gut bacteria to enterodiol and enterolactone, which have weak estrogenic or antiestrogenic effects at physiological levels and perhaps act through other mechanisms (aromatase inhibitors?). I’ve searched and come up empty trying to find their comparative binding affinities. Studies are mixed, but they appear to have benefits in reducing prostate and breast cancer progression. Here’s a review.

                  Coumestrol was covered in the highly cited Kuiper et al 1998 study. Its had much more affinity for ERα than other phytoestrogens, and while its affinity for ERβ was still 3-7 times greater, this is much less selective than the soy phytoestrogen genistein. Dietary coumestrol was found inversely associated with ER- BCA risk in this study.




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          2. Darryl, I don’t know if that “rubber key” metaphor is an original with you but I found it delightful and very enlightening. I will not forget that image.




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  2. Dr. Gregor, I love all your work and am disappointed at your comment on this video, about the “Quack clinic in Mexico”. Do you know for sure that this clinic is Quack? If you are speaking of the Gerson institute then you are wrong! There are many people out there who have survived cancer and other diseases because of Max Gerson’s brilliant discovery.

    Check it out for yourself before you slander a clinic dedicated to helping people get their lives back form ravaging diseases.




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    1. He didn’t name any particular clinic. I’m pretty confident there are some quack clinics in Mexico. Certainly, I like the raw juice diet aspect of Gerson, and there is likely financial bias in many of the studies of Gerson patients, but perhaps a whole-foods, plant-based diet is superior to Gerson. Coffee enemas and injected calf liver from Gerson are two procedures that don’t seem to offer benefit, in my mind, unless they can publish their studies, ideally with peer review.




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    1. There are many in vitro studies using the TNBC cell lines in table 1 of Chavez et al 2010. Plugging sulforaphane and that list yielded about 1120 results in Google Scholar, but many of those mention sulforaphane in passing. I’d start with the 8 results in PubMed where sulforaphane and one of the TNBC cell lines are mentioned in the abstract.

      , and plug them in with “sulforaphane” in PubMed, or better (because it searches the text), Google Scholar.

      Tea+broccoli vs triple negative MDA-MB-231 line




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        1. Typically you would find an extract of the broccoli, such as a component from the food to the pill. Although yes sulforaphane is a potent phytonutrient, there are thousands of other phytonutrients at play when eating the whole plant food. Isolating one component of that food and consuming it usually does not result in the same health benefits as eating the whole food would.




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  3. Thanks for the positives in this and other vids. Lets encourage our friends and families to be healthy. Lets think before we speak…We can all improve and should try to do so. You might want to try to constrain the attitude. I’ve been in that chair, got some very bad news and hit rock bottom before slowly climbing out of the pit. The advice I got was all bad. Pure chance led me to Essy’s FOK and it all fell into place after that single lucky event. So you can believe me that I know whereof I speak. IF I had been aware of the power of this way of living I and most people would have made the changes early.

    I witnessed my mothers struggle with diabetes and her increasingly desperate efforts to “fix” her diet with various diets. She taught me what she believed was best for me. Then it was my turn. History repeats. We all get the same load of bull coming at us from all angles. It does no good to be superior… to berate people for their ignorance no matter how frustrated you may feel. When you do that you sound just like a …. doctor.

    When you score points by degrading peoples diet choices you risk losing them. When we lose them they die badly.

    You sound like you are pandering to your loyal groupies more than trying to reach people. You might benefit from considering reading a book about persuasion. Youre getting too full of yourself mate.




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    1. I have utmost respect for the doctor and his work, but I just couldn’t forward this on to my friend who was diagnosed two years ago. I do usually send her links to research showing improved breast cancer survival rates. I’m not sure I felt he was too full of himself, but I felt it might make her re-live the trauma of being told by the doc that her lump was cancerous.




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      1. Yes exactly…thanks. In our case, our oldest dearest friends started referring to her in the past tense…in her presence! Cripes. Can’t people think a little before speaking?




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  4. Anyone care to share their recipe for a delish vegan broccoli soup? I’ve been try to concoct one, but have not found one that I really like yet.




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      1. Looks good but boy so does that Ginger Squash soup! I think I might try that one first :)

        Here’s another blended green soup (can use any cruciferous green leafies or broccoli or both). I like to add a little rosemary to it. I also omit the oil and use regular ol brown rice. The rice blended into it gives it a wonderful thick and creamy texture.

        Also the directions as written are kind of involved, but I just caramelize the onions, then cook the crap out of everything else, then blend. I do it all in one pot and use an immersion blender.

        http://www.splendidtable.org/recipes/basic-green-soup




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        1. Re: Brenda’s Ginger Squash soup, what would you suggest in place of coconut milk, which is high in saturated fat?
          Btw, thanks for your response and link.




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          1. In a couple Thai recipes, I’ve used soy or almond milk with 1/4 – 1/2 tsp coconut extract per cup milk. I got the suggestion from fatfreevegan or the Healthy Librarian, can’t remember which. And come to think of it I think they got it from Ann Esselstyn. Anyway I think it tastes great, plus once you have the little bottle of extract, as long as you have milk in the fridge you always have “coconut milk” on hand. Which otherwise for me would be a special trip to the store.




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            1. b00mer: re:”coconut extract” Very interesting idea! I want to try that too.

              I also thought I would share my initial thoughts: The idea didn’t make sense to me initially, because most of the time when I am using coconut milk, it seems that the recipe is wanting the high-fat / saturated fat nature of the coconut milk. Especially for savory dishes, I thought the inclusion of coconut milk had more to do with tradition and texture than with taste.

              But then I thought about how Dr. Barnard talks about people’s natural adjustment from drinking say whole milk to 2% or from 2% to skim. It tastes watery at first, but then you get used to it. So, I imagine the same would be true with your/fatfreevegan/Healthy Librarian’s trick — with even less of an adjustment since the “milky” coconut milk that comes in cartons is not really any thicker than say soy milk I think. Also, I was thinking that adding some strong coconut flavor might make a difference taste-wise and really enhance a dish.

              Just sharing some thoughts with you. I appreciate the idea. I can see how it has potential!




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  5. Dr. Greger is making a mistake by linking cruciferous vegetables with the prevention of just one type of cancer (breast cancer) or with just one group of cancers (hormone-dependent cancers). The truth is that cruciferous vegetables prevent ALL cancers extremely well and they also prevent heart disease, stroke, brain diseases, bone diseases, lung diseases, kidney diseases, liver diseases, pancreatic diseases, intestinal diseases, vision loss, hearing loss, etc:
    http://www.ncbi.nlm.nih.gov/pubmed/16227704

    Just remember that cruciferous vegetables need to be eaten raw and that boiling them will destroy about half of the beneficial glucosinolates.
    Freezing them will also destroy about half. Freezing then boiling cruciferous vegetables will destroy about three-quarters of the beneficial glucosinolates. Fortunately, most other vegetables can be boiled or canned without too much destruction of their beneficial disease-preventing phytonutrients.




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    1. He just did a video a few days ago explaining how to prepare cruciferous veggies OR eat them with mustard, horseradish or wasabi – the sulforaphane and the precursor are thermally stable, the enzyme to convert the precursor to sulforaphane is not and is destroyed by cooking or blanching for freezing. But if you chop them up and let them sit before cooking them or eat them raw the enzyme will do its job; or if you add the enzyme which is present in the bitter herbs it will also do its job on the cooked veggies.




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  6. Dr. Greger,
    What is your opinion on the ketogenic diet for cancer patients in which total carbohydrates are limited to 20-30 grams per day. Total fat grams plus total protein grams in a meal is generally kept at a 3-5 ratio to one gram of carbohydrate. From what I have been reading, this limits the amount of carbohydrates used by cancer cells. Is this effective in cancer treatment?
    Thank you,
    Daisy




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    1. Not effective. First of all, fat and protein and carbohydrates are not food groups. If you review this site you will see it does not advocate refined oils or animal products or supplements but generally eating whole foods, all plant based. You will never get more than 10-15% protein or 10-20% fats eating whole foods and never get to less than16-25% carbohydrates on such a diet unless perhaps you eat nothing but avocados, nuts and coconut. Dr. Greger wrote the book on scam low carb diets. Better to get fiber and phytonutrients.




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  7. Dr. Greger, in this video, you mention that “there’s a new experimental treatment that can cut your chances of dying in the next few years from like 16% down to just 4%. To quadruple their survival rate many women would re-mortgage their homes…” I believe there is an error here. My father pointed out that “cutting the chances of dying from 16% to 4% does not quadruple your survival rate. The rate increases from a good 84% to an excellent 96%, a substantial benefit but hardly a quadrupling….” I believe that it would be more accurate to say that it quarters one’s death rate.




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  8. I really like your site and even donate, but find some of your comments, like “quak clinic in Mexico” to be absurd. Are you trying to imply allopathic medicine is better than alternative approaches? Chemo is a total scam and outright crime against the public, just like stints, open heart surgery and drugs for type II diabetes. Have we not figured out by now that diet and lifestyle is the real answer to the problem? Belittling alternative treatments is quite honestly arrogant, irrational and only proves narrow mindedness! A doctor opens a cancer clinic in Mexico, because he is limited in his treatment options, namely: radiation and chemo, both of which do not work. While not the greatest book, “Radical Remission” is only the beginning of the truth that is starting to leak to the public. We need to stop being a tool for the drug industry, and the cancer industry is one of their number one cash cows. Some of these older videos should be removed or updated.

    This is an excellent place to start our cancer research: https://vimeo.com/15841984

    Chris also has a worthwhile story to tell: https://www.facebook.com/chrisbeatcancer/




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  9. My friend stopped using birth control pills a few months ago, after 15 years of using. 2 main concerns have raised up due to this:
    1. She started to have hormonal acne issues.
    2. Here women doctor is pushing here to go back on birth control pills to reduce cancer risk.

    We usually go witha finger rull of organic and vegan. So taking any kind of pill to prevent neither cancer or acne dosent feels right.

    Will appreciate an advice.




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  10. My daughter just received the devastating news today, post having bilateral mastectomy, that she has Inflammatory Breast Cancer. Her diet consists of 80% plant based whole foods, but she is now torn with the decision of going along with the oncologist’s recommendation to have chemo and radiation (she is scared) or go along with a stricter WFPB diet and exercise. Your response would be appreciated.




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