Book Review - SCAM: So-called Alternative Medicine

Keywords: Homeopathy, alternative medicine Title:SCAM: So-called Alternative Medicine Author: Edzard Ernst Publisher: Imprint Academic ISBN: 978-1845409708

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‘SCAM – So-called Alternative Medicine’, is the follow-up book to ‘A Scientist In Wonderland’, Edzard Ernst’s very readable memoir. That book, reviewed here previously, Ernst told the story of how he came to be the first Professor of Complementary Medicine in the world. It was a post that was greeted enthusiastically by those who were true believers in homeopathy, healing crystals and other forms of ‘alternative medicine’. These true believers assumed that anyone taking on that role would be like minded. Unfortunately, Ernst decided that he was a scientist first and foremost and that his job meant applying the scientific method to the extraordinary claims made by practitioners. The fall out reached a peak with a very public falling out with Prince Charles and trouble for Ernst from his own university. It’s an interesting story well-told in the first book.

In this book Ernst is continuing the work that got him into so much trouble. Here he outlines how these various alternatives seem to work – their common features, imperviousness to evidence, the magical thinking and conspiracy theories that believers use to counter the lack of evidence. For example, many alternatives claim that much of contemporary medicine also doesn’t stack up and hasn’t been tested vigorously in clinical trial. While there’s a smidgen of truth there, Ernst points to the evidence that in conventional practice 80% - 90% is evidence-based (and includes the reference so you can look at the original paper itself).

While the book lacks the narrative from the first – after all that was a memoir – it does run over some of the elements of his own experience in battling with Prince Charles. It’s a book that is informed by long experience talking to people who really do believe in homeopathy and so on. Some of the people who peddle this stuff really do believe it and have the best of intentions. But there are some very cynical, mercenary people who are driven entirely by selfish reasons to exploit vulnerable people when they are sick. But perhaps, as Ernst suggests here, there’s a third group – people who convince themselves and make a nice living at the same time.

Overall this is certainly an interesting read – with plenty of useful information with which to counter fraudsters and fakes. There’s even a section on how to set yourself up as a charlatan – yep, you too can claim to cure cancer, fight dementia and tackle bad breath.

The Star Throwers Guide To Cancer

One of the reasons for starting this website was the wish to share information with patients, carers and other people directly affected by a cancer diagnosis. The site came out of a series of discussions I had with my son George while he was in the middle of his battle against osteosarcoma. We wanted a site that could be used to share science-based information that was likely to be useful, particularly for people looking for treatment options, as we often were. However,  I have to admit that in recent months the site hasn’t been getting the attention it used to – the number of new postings has been really light on the ground. One of the reasons for this has been that for a long time I had been working with the UK charity Star Throwers to produce a book that would provide a lot of that type of information in ebook and paperback form.

The Star Thowers Guide To Cancer, as the book is called, is now available via Amazon or, if you’re in Wymondham, Norfolk, direct from Star Throwers. The book covers similar ground to this website: science-based, heavy on information, concise and geared very much to looking at new treatment options. Does the world really need another new book on cancer? Book shops are full of new cancer books: memoirs, diet guides, histories of oncology and much more. But this one is different.

I like to think of this book as a ‘how to be a difficult patient’ guide. It shows you how to read the cancer literature. How to assess the breathless stories about new ‘cures’ that are frequently highlighted in the mass media. There is a detailed discussion of the tricky subject of cancer and diet. Searching for clinical trials and looking for treatments abroad are also covered in some detail. Local ablative treatments such as cryoablation are covered, including the vital information on where to look for these useful but underused treatments. Finally, there is also a chapter on drug repurposing, a topic I have covered here many times and which I now work on pretty much full-time.

In the past I have considered taking the best articles from this site and putting them together as a single download via PDF. But there’s no need now. This book provides the best of this site and much, much more.

Book Review - A Scientist in Wonderland

Keywords: Homeopathy, memoir, medicine Title:A Scientist in Wonderland Author: Edzard Ernst Publisher: Imprint Academic ISBN: 978-1845407773

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Edzard Ernst initially came to prominence in the UK as Professor of Complementary Medicine, holding the first such chair anywhere in the world. That was in 1993, and Ernst, who already had a pedigree both as a clinician and a researcher, expected that his quest to rigorously apply the scientific method to the various fields of ‘complementary and alternative’ medicine would be welcomed by practitioners and adherents who would want to prove the efficacy of their different ‘modalities’. Now fast forward to 2015 and Ernst is in the public eye once more in the UK with the publication of ‘A Scientist in Wonderland’, his memoir that tells the story not just of his research findings, but also lays bare the meddling of Prince Charles, heir to the British throne and arch-proponent of homeopathy, detoxification theories and a raft of other ‘alternative therapies’.

The book describes Ernst’s circuitous route to that Professorship – from his unconventional upbringing in post-War Germany, his love of jazz and his hesitant move into medicine. This is an environment in which homeopathy and naturopathy are accepted to a greater extent than in the UK. Indeed his first posting is in Germany’s only homeopathic hospital, where patients seemed to respond well to the endlessly diluted concoctions which are homeopathic medicines. As he points out in graphic detail, there can be not a single molecule of active ingredient left in these medicines, but yet patients recovered. Evidence of effect? Or evidence of the natural evolution of many illnesses and the positive power of the placebo effect?

In time Ernst moves to more conventional medical institutions. In addition to growing clinical experience he also begins a research career, finding the role of scientist enormously rewarding and intellectually satisfying. His observes, wryly that:

An uncritical scientist is a contradiction in terms: if you meet one, chances are that you have encountered a charlatan. By contrast, a critical clinician is a true rarity, in my experience. If you meet one, chances are that you have found a good and responsible doctor. 

There are certainly plenty of patients who will echo that, and indeed it is a complaint that many cancer patients will recognise. Indeed, many of us hope that the Medical Innovation Bill (aka the Saatchi Bill, which Ernst does not support), will encourage more of this critical and scientific thinking in our doctors.

Book Review - 'Being Mortal' by Atul Gawande

Keywords: Cancer, aging, medicine Title:Being Mortal: Illness, Medicine and What Matters in the End Author: Atul Gawande Publisher: Profile Books ISBN: 978-1846685811

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In 'Being Mortal' Atul Gawande asks a series of difficult, important but uncomfortable questions about the nature of medicine and mortality. These are tricky waters to navigate, but essential all the same as it gets to the heart of what it is we want medicine to do for us. But navigate them we must, both because we have an aging population that often faces impossible choices regarding social care and also in the context of increasing cancer incidence (one of the consequences of that aging).

The author, a practicing doctor, uses the experiences of family, friends and patients alike to illustrate the choices that face us both in aging and in cancer care. He skilfully weaves in these experiences and in doing so puts complex problems into real situations so that he explore the options available, the things we want and cannot have and also, just importantly, draws out the underlying questions. He explores the history and evolution of patient care, how changes in the pattern of work and family life have impacted our expectations of old age. The contrasts between what we want in terms of autonomy and quality of life on the one hand, and what our medical and social care systems provides on the other are brought sharply into life. For those of us who have had to navigate these problems for elderly relatives it is familiar territory outlined with a thought-provoking honesty.

In terms of cancer the problems are starker still. When treatments fail what do we want to do? We are up against the limits of what medicine can deliver. Up against what our medical systems can cope with. The dilemma here is to risk cripplingly expensive new treatments, often with horrendous side effects or to opt instead for palliative or hospice care. These are hard choices to make, assuming we are given the choices in the first place. Sometimes there are less toxic options to try, but many doctors seem to prefer to go for the toxic chemotherapy route rather than step back and look at what the patient wants.

If there’s a theme that jumps out from this book it is that we need to be moving to a different model of the patient-doctor relationship. Dr Gawande describes this admirably. There is the doctor as expert doling out wisdom from on high. There is the doctor as information source giving facts and figures impartially to patients ill-equipped to come to a decision. And then there is the hardest option of all, which is the doctor as partner to the patient. A doctor who engages with the patient to discover what it is that is most important to them and then to help the patient make the choices that deliver the best compromises that are possible. Unfortunately many doctors are simply not trained or don’t have the tools to take this role, which is hard on the patients but hard too for the doctors.

While this is a challenging book at times, it is never sentimental or emotive, it’s humane and concerned. Medical systems the world over are in flux, struggling to cope with the increases in demand that our successes in medicine have delivered. In many ways we should not lose sight of how much progress we have made. But neither should we be happy with the status quo that leaves so many patients poorly served. Something has to give. And perhaps part of what has to give is that old-fashioned view of the doctor as expert, with the patient as passive receiver of care with no say in their own treatment.

Book Review - p53 : The Gene That Cracked The Cancer Code

Keywords: Cancer, p53, Li Fraumeni Syndrome Title: p53 : The Gene That Cracked The Cancer Code Author: Sue Armstrong Publisher: Bloomsbury Sigma ISBN: 978-1472910516

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If any single gene deserves a biography, it’s TP53 (more commonly known as p53). This is the gene, memorably christened the ‘guardian of the genome’ by David Lane, one of its co-discoverers, which is the tumour suppressor that is most commonly lost or mutated in cancer. It’s also the gene most commonly mutated in the rare and deadly cancer predisposition condition called Li Fraumeni Syndrome. Science writer Sue Armstrong has crafted that biography, delivering a book that is engaging, interesting and has a real page-turning quality that you might not expect for a book on the workings of a single gene.

Adopting a largely historical narrative, the book explores the evolution of our understanding of cancer via our expanding knowledge of p53. Early on, before the structure of DNA was unravelled, scientists explored the viral transmission of cancer in animal models – sarcoma viruses could reliably infect animals with tumours. If it worked for animals, they reasoned, why not for people? How did the virus create tumours? Investigations showed that these viruses triggered changes in cells that eventually developed into cancers. Individual genes and pathways were discovered that were termed oncogenes – these were the culprits that caused cancer.

But of course most cancers that develop in people are not virally transmitted, but as technology and scientific tools expanded the theories developed and changed. Our understanding of DNA spawned a revolution in our thinking, including our thinking about cancer and the role of genetic change. When it was first discovered – independently by multiple groups – p53 was assumed to be just another oncogene, a driver of cancer development.

For The Love of George - Book

The starting point for this blog was a conversation with my son, George, in the middle of his battle with osteosarcoma. I’d had been immersed in reading about treatments, supplements, theories and he thought that it would be good to share that knowledge with other people. We talked about it for a while and he came up with some ideas for a logo, we talked about the domain name and so on. It was typical George, thinking about the future, coming up with plans and schemes. The other web site he was really keen on starting was eat positive, that was one he was really keen on and I’m glad that I’ve managed to kick that off in a very low key sort of way too. Unfortunately not every story has a happy ending, and George did not live to see either of these sites become real. And of course after his death we created the George Pantziarka TP53 Trust to support other individuals and families afflicted with Li Fraumeni Syndrome in the same way that he was.

But for all this activity, I do sometimes worry that people will lose sight of who George was. He was a kid who suffered three different cancers, and who tried just about every treatment available before finally succumbing to the disease at the age of 17. It’s a painful story, but one that is common to families with LFS, or to families with a child with cancer. It’s a story that needs telling. And to that end my wife, Irene Kappes, has written a book called ‘For The Love of George’. I’ll be honest, it’s not an easy read. It doesn’t have a happy ending, though we all hope that what we are doing in his name can make something positive out of what he went through.

We worry that the book is harrowing and will scare some people, but then how can we make clear what families with LFS have to go through if we’re not honest? The only way is to show what George was like. To show what a fantastic kid he was, how we had good times even when the medical situation was grim, and to hope that there things in the book that people can learn from.

A portion of the proceeds from the book will go into the Trust.

The book is available on Kindle and as hard copy from Amazon.

In the UK: Kindle or Paperback

In the US: Kindle or Paperback

Book Review - Surviving 'Terminal' Cancer

Keywords: Cancer, glioblastoma, drug cocktails Title: Surviving Terminal Cancer Author: Ben Williams, PhD Publisher: Fairview Press ISBN: 978-1477496510

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While there are some cancers for which we have made progress in treatments and consequent survival, there are also some for which progress has been pretty much non-existent. Glioblastoma multiforme (GBM) is one of the latter – the survival statistics are abysmal and have remained unchanged for many years. Which is why this book, by professor of Psychology Ben Williams, is so inspirational. When faced with this terrifying diagnosis, he got through the shock and then decided he was going to do more than just sit back and accept the standard of care treatment that was almost guaranteed to fail. Instead he took matters into his own hands and sought out other options, whatever and wherever they might be. He is, therefore, one of the few very long-term survivors of GBM. What is more, he has done more than just seek out something for himself, and he has dedicated the last twenty years to helping others do the same. This book is his story and it is, without doubt, one of the most inspirational and yet practical books in the vast literature of cancer.

Written in three sections, ‘Surviving Terminal Cancer’ is more than just a memoir, it also includes a section on the need for change in the system of clinical trials and drug development and a final section on some of the specific treatments and supplements that Williams has found to be useful. In all this is a comprehensive range of material that moves far beyond a memoir and becomes more of a manual for the activist patient who wants to go beyond what the standard treatments.

The book starts, however, with Ben William’s own story. He describes the terrifying diagnosis and his initial shock and paralysis in the face of it. But this changes as he responds by using his skills as a scientist to understand the disease and to look at what was being researched. Over time he expands this to develop an approach to his treatment that incorporates multiple additional treatments over and above the standard treatments in place. In the process he comes face to face with an oncological community unwilling to experiment or offer additional choices even when they know that outcome will be dismal. If people are going to die then why is it unethical to treat them with non-standard drugs?

The memoir is profoundly moving and also disturbing in that it reveals a degree of conservatism in the oncology profession that does no favours for patients. 

The next section of the book picks up on many of the issues that his own direct experience raised regarding medical institutions, clinical practice and the clinical trials process. The issues raised are not unique to Ben Williams, nor specific to glioblastoma or even cancer in general come to that. The system is clearly not optional, and it actively inhibits change. It is a system designed for regulators and bureaucrats and the needs of patients are low on the list of priorities. The clinical trials process in particular has continued to evolve towards very large Phase III trials that are expensive, time-consuming and often lead to minor incremental changes in outcomes, if at all. Ben Williams does not argue for doing away with trials completely, instead he argues for smaller and more focused trials leading to changes in clinical practice in a way that is more responsive to good results.

In the final section of the book – suitably entitled ‘What your oncologist won’t tell you’ – the attention turns to ‘alternative’ medicine, supplements, and the current state of play in cancer research.  The arguments about what counts as ‘alternative’ are well-rehearsed, and there is an examination of some well-known controversies regarding laetrile, iscador, the case of Stanislaw Burzynski. The pros and cons of each are discussed, in some detail with regards to Burzynski, but what is more important than the details of each is the process of sifting out the details that Ben Williams goes through. In a world where there are numerous scammers promising miracle cures, arming people with the tools to recognise junk science is essential.

In all this is a fantastic read. It’s thought-provoking, polemical, honest and hopeful. What is more, the approach that Ben Williams is suggesting applies to more than glioblastoma and other brain tumours, it applies across the board to cancer.

Book Review: Mammography Screening: Truth, Lies and Controversy

Keywords: Cancer, screening, medicine, public policy, science Title: Mammography Screening: Truth, Lies and Controversy Author: Peter C. Gotzsche Publisher: Radcliffe Publishing Ltd ISBN: 978-1846195853

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On the face of it the case for increased breast cancer screening is clear. Cancers caught sooner are easier to excise or to treat with chemotherapy. Earlier diagnosis means a lower likelihood of metastases, which are the real killers in cancers of all kinds. So who could argue against increased screening? Unfortunately this simple picture, seductive though it is, is just too simplistic and obscures a bitter controversy that has raged across the medical literature but which barely registers in public consciousness.

Peter Gøtzsche, a Danish medical researcher, Professor of Clinical Research Design and Analysis and the director of the Nordic Cochrane Centre, is a key player in the controversy and is highly sceptical of the value of breast screening in the general population. As an expert in clinical trial design and results analysis he came to the topic with no real experience of breast oncology, chemotherapy or surgery. But it was from this position of independence that he looked at the data from the studies that had been performed on breast screening and decided, based on the evidence that he and his colleagues uncovered, that far from being an unalloyed good, there were real and significant harms being perpetrated on women taking part in breast cancer screening programs.

As Gøtzsche outlines in considerable detail in this book, his findings were not greeted with open arms by breast screening advocates, the medical establishment and numerous well-placed political and academic figures. In fact the reaction was extremely hostile and remains so to this day, many years after his initial research findings. Gøtzsche and his colleagues were attacked from all sides for straying from the 'consensus' view that screening saved lives. His results, methods and motives were all attacked and continue to be attacked, though few seem to actually dispute the core of what he has found.

And what is it that makes Gøtzsche and a few others like him dispute the simple narrative that regular screening saves women's lives? The fly in the ointment is simple - over-diagnosis. If you go looking for cancer then cancer is what you'll find. Mammography screening will find all kinds of lumps and abnormalities. Some of these will become invasive and dangerous cancers, many will not. The difficulty is that at this stage we don't know which will melt away and which will turn into killers. Given that we can't tell the difference the only thing to do is to aggressively treat all the tumours that we find. And, let's be honest, this treatment is often brutal - mastectomy, radiotherapy and chemotherapy.

In analysing the data Gøtzsche focuses on overall all-cause mortality. And his key finding is truly shocking - while some women might be saved by early diagnosis and treatment, others will die from over-diagnosis and the results of over-treatment. In their latest advice, Gøtzsche and his co-workers state that:

Screening produces patients with breast cancer from among healthy women who would never have developed symptoms of breast cancer. Treatment of these healthy women increases their risk of dying, e.g. from heart disease and cancer.

This is not a trivial finding it's a scandal that ought to have anti-cancer activists up in arms. Unfortunately many activists are so wedded to the idea of mammography being the panacea that they campaign for increases in screening rather than wanting to subject the programs in place to the critical scrutiny they deserve.

For those of us familiar with that other science war - climate-change - some of what Gøtzsche describes will be eerily similar: well-entrenched 'consensus' science subjecting sceptical voices to attack, subversion of peer review, ad hominen attacks, endless dissimulation and the knocking down of strawman arguments that sceptics do not make. The parallels between this and what goes on in 'climate science' are strong, obvious and depressing. Even more depressing is the fact that Gøtzsche himself seems to have fallen for the party line when it comes to climate change, not realising that scientists sceptical of the 'consensus' view of man made climate disaster are also subject to subverted peer review, ad hominen attack, accusations of working for commercial interests etc. Where he is accused of killing patients, anthropogenic global warming sceptics are accused of wanting to kill the planet.

Gøtzsche describes in great detail the many controversies and arguments that have ensued since going public with his results. There is a degree of repetition throughout the book, but at its core is a simple story based not on complex statistical analysis or mathematical modelling but on the raw data of what happens to women taking part in screening programs.

Where he comes back again and again to the inevitable fact of over-diagnosis, the advocates of screening focus on the fact that earlier diagnosis leads to improved outcomes for the women diagnosed. Both these things are true. But in terms of women in general, it means that large numbers of women are being turned into cancer patients unnecessarily, and that some of these will die because of the treatment they receive.

This isn't to say that screening is a bad idea per se. For women with genetic predisposition, with family histories of breast cancer or who are in other high risk groups then screening make sense. However, for the vast majority of women who are not at high risk, especially younger women, screening does not make sense and will lead to harm to a number of them. In fact Gøtzsche and the Nordic Cochrane group have published a leaflet for women, setting out the benefits and risks of screening, leaving it to women to make up their own minds based on a clear exposition of the data. It can be downloaded here: http://www.cochrane.dk

And, despite the accusations of his opponents, Gøtzsche is not alone. For example, Michael Baum, who worked for 30 years as a surgeon specialising in breast cancer, and is now professor emeritus of surgery at University College London, recently stated:

If we stopped screening today, the incidence of breast cancer would fall at a stroke by about 25 per cent.

In the end Gøtzsche's book is like the cancer version of Andrew Montford's 'The Hockey Stick Illusion'. Both books look at contentious areas of science. Both books cut through often obscure statistical arguments to get to the core of the issue. And both books describe a situation where you have tightly knit and entrenched groups of scientists with institutional backing, political support and significant funding doing their level best to lock out those who refuse to bow down to a 'consensus' that is not grounded in solid science.
Or as Gøtzsche puts it:

The screening literature has been polluted to an extraordinary degree by statistical modelling of raw data, often combined with wishful thinking and the use of favourable, but unrealistic assumptions for variables that cannot be measured. This has helped conceal inconvenient facts and has yielded results people wanted to see.

To conclude, this is essential reading for everyone interested in science, medicine and public health policy. Most of all it is essential reading for women being emotionally blackmailed into taking part in screening programs without being given all the facts.

The 2-Day Diet

It may seem odd to find a review of a diet book on a web site devoted to cancer, but there are good reasons for looking at this book. Firstly, it's an accepted fact that there is a strong link between obesity, metabolism and cancer. Secondly, there is an increasing view among some researchers that cancer is a metabolic syndrome, and that cancers are associated with a whole set of metabolic changes, both in the tumour and the surrounding tissues. Cancer and metabolism, and therefore diet, are inextricably linked. And, as discussed on this site in the past, there is evidence that altering diet can impact cancer treatments as in the work that looked at chemo response and fasting. There is another reason for looking at this book - the authors (Professor Tony Howell and Dr Michelle Harvie) are both working in breast cancer research, and are involved specifically in helping patients reduce their chances of getting the disease or reducing the risk of recurrence. One of the authors, Tony Howell, is well known to regular readers of this site for his work on the reverse Warburg effect and his association with Michael Lisanti and the development of new theories that link cancer with metabolism.

That said, this is primarily a book about diets and losing weight rather than a book specifically about cancer. Although the links to cancer are there in the text, and many of the patient stories include mention of cancer, the main aim is to help readers lose weight and keep it off. And, in doing so, to reap the overall health benefits across the board.

So, what is the 2-day Diet, and how does it differ from the thousands of other diet books on the market? A key point to make up front is that this is a diet that's been backed up by clinical data. There are no celebrity endorsements, no one selling expensive supplements or foods, no hand waving or bold claims unsupported by evidence. This is a diet that has been shown to work, it's that simple. Simple too is the basic idea behind the diet - it's simpler to stick to a strict diet for two days per week than it is for seven. And, importantly, the changes induced by a strict two day a week diet are significant enough to cause changes in body weight, glucose tolerance, mood and so on.

Is Mammography Screening Always A Good Idea?

I had, like most people, always assumed that mammography screening was a thoroughly good thing. If there was a controversy about, I had assumed it would be one that would come down to costs versus benefits. The assumption being that the only thing stopping mammography screening being rolled out to younger women was just about money. At no point had it ever occured to me that there might be scientific controversies associated with screening. That was until I found out about Peter Gotzsche and his argument that mammography screening was actively harming women. My first thought was that this must be about sloppy diagnosis - if women were being harmed it was because some of them are being misdiagnosed and then subjected to the array of harsh treatments - chemotherapy, radiotherapy and radical surgery. But no, his point is more subtle than that and comes down to basic oncology. His key finding, based on the data from randomised clinical trials, is that women are being over-diagnosed. And it wasn't until I read his book, Mammography Screening: Truth, Lies and Controversy (which I have reviewed here: http://www.londonbookreview.com/lbr0067.html), that I got the point.

In effect it boils down to a simple fact - not all breast cancers will grow, spread and ultimately kill the women who develop them. There are cancers that are slow-growing or which sprout, shrivel and die and which actually do not cause any health problems whatsoever. Many women will develop these types of tumours and never even know it. The problem is that we don't have any clear way of differentiating between these tumours and the ones that turn into killers. What screening does then is pick out all tumours - the safe and the dangerous. And because we don't know which is which doctors have no choice but to treat them all. It's not that women are being misdiagnosed, the tumours that are picked out are real, it's that some of those tumours are less dangerous than the treatments that follow.

Book Review - Foods To Fight Cancer

A version of this review was first published at LondonBookReview.com

Title: Foods to Fight Cancer
Author: Richard Beliveau and Denis Gingras
Publisher: Dorling Kindersley
ISBN: 1405319151/0756628679

Cancer patients, and their friends and families, are often faced with contradictory information on what to do about diet. On the one hand there are large numbers of mainstream oncologists and dieticians who tell patients to eat what they like so long as they keep the calories up and are able to get through chemotherapy or radiotherapy. On the other hand there are plenty of people who insist that only a strict vegan or macrobiotic or Gerson or other anti-cancer diet will help. And of course there are lots of books out there that advocate all kinds of diets, all of them claiming to be based on some sort of science. Those looking for a middle ground based on solid science are left trying to work out for themselves what makes sense and what is obvious nonsense.

Foods To Fight Cancer looks like lots of other books in the 'superfoods' genre. It's glossy, well illustrated and published by Dorling Kindersly. It looks more coffee table than operating table. However, unlike many of the anti-cancer food books that are on the market this one is written by scientists working in the field of diet and cancer and who are not only up-to-date with the science but who are engaged in making it happen. It just so happens that Richard Beliveau and Denis Gingras are excellent communicators able to write for the non-scientist as well as their colleagues.

The central premise of the book is that dietary interventions can help tip the odds against developing cancer, and also to aid in fighting cancer once it has started. The plant kingdom contains thousands of phytochemicals - polyphenols, terpenes, sulphides etc - which have potent anti-cancer properties. These micro-nutrients act in multi-faceted ways to block many of the different biological pathways necessary for cancers to form, grow and then metastasize. Unlike some of the over-inflated claims made by some, there is no promise of a single all-powerful cancer cure here. Instead the emphasis is firmly on looking at what pathways are necessary for cancer to develop and then what can be done to block these using multiple compounds from different foods.