Cancer

I flew to Anchorage, Alaska, in the spring of 1990 and the news was bad. Hunting for ivory had fallen into ill repute. To save Africa's elephants a world-wide ban on ivory trade was now in effect. There had been reports in magazines and in Alaskas press of Inuit "headhunting, of killing walruses only for their tusks, leaving the headless carcasses upon the ice. The more lurid reports spoke of "chainsaw gangs" that lopped off walrus heads. The Diomeders, I guessed, would be very touchy. A Japanese TV crew, I was told, had offered the Diomeders big money to film the walrus hunt and had been curtly advised that they and their money were not wanted. "I wouldn't be surprised," a biologist friend in Anchorage told me, "if they put you back on the helicopter and tell you to fly off." 

That was another change: a heliport at Diomede and weekly helicopter service from Nome. It all looked so familiar: the fields of ice in Bering Strait; the soaring cliffs of Diomede; the weather-gray houses glued to the mountainside; the umiaks on their racks; the great rust-red tanks for oil and gas. I stared down and worried about my welcome. The helicopter landed on a new metal pad on the beach. There was the familiar smell of sea and wrack and walrus oil. And there stood Tom Menadelook and Mary. He recognized me instantly and was as brief and decisive as ever. "Good to see you back," he said. "Mary and I are going to Portland [Oregon] for Etta's graduation. You can stay at our house." Junior," he called, and from the crowd around the helicopter came a heavyset, sturdy young man: Tom, Jr., now twenty-six, father of three lovely children, a fine hunter, and the village policeman. "This is Fred," his father said. "He'll stay at our place. Get him the keys. And he'll go out again with our boat." All my worries vanished. 

Young men carried the bags up to "my" house. I followed slowly, up the steep, familiar cobbled path. Annie Iyahuk sat on the steps of her house. "Come in," she said. "Albert will be glad to see you." Albert, with whom long ago I had collected greens on the slopes of Diomede, now in his seventies, was thin and frail but still an excellent carver. He grasped my hand in both of his. "Ah," he said. "You came back to us." I was given tea and bread, and hard-boiled eggs with seal oil. After fifteen years, it was like coming home. 

There had been many changes in these years: a large new school had been built, a new store, some new houses, a "washateria" owned, like the store, by the islanders and paid for, in large part, with money made from ivory carving. It was kept spotlessly clean and for three dollars one could shower, wash a load of clothing, and dry it. The washateria brought in $100,000 in its first year of operation. 

There was one drastic change: Diomede was dry. All alcohol was forbidden. The planes with booze, the wild parties, the fights, the smashed windows, the drunken threats, the bilious hangovers were now only memories of a violent past. "It sure is quiet, kidded George Milligrock, once one of the wild young men of Diomede and now approaching portly middle age. "Yes," he agreed with a touch of regret, "we're getting to be quite civilized." Young Inuit who had tried city life in Nome, Anchorage, or Seattle and were nearly crushed by drink and other problems, had returned to Diomede, to their roots, to an older, simpler way of life. The population of Ignaluk, after shrinking for many years to a low of 84 in 1970, had increased to 121 in 1975, and to 171 in 1990. 

Life on Diomede was peaceful, pleasant, quiet. It certainly was a nicer, gentler place than on my first visit - and yet, some of the panache, the verve, that devil-may-care daring was gone, and at times I felt a certain perverse nostalgia for the wildness of the bad old days. 

"Civilization" also seemed to have exacted a bitter price. Once Diomeders had been famous for their daring and their vigorous health. The Smithsonian Institution anthropologist Ales Hrdlicka visited Little Diomede in 1926. "The natives look sturdy, " he noted. "None other could survive here." Shortly after I arrived, I met John Iyapana who, on my previous visit, had taken me by umiak back to the mainland. I remembered him as a weather-beaten, bluff bear of a man, violent when drunk, affable when sober, with an immense fund of stories about Diomede. Now he was a broken hulk, wan and weak. He pulled a notebook from his pocket and wrote: "Welcome back, Fred! Cancer had destroyed his throat and vocal cords; he could no longer speak. He would never tell stories again. 

"Long ago, when I was young, said Albert Iyahuk, "people were never sick." Now cancer and heart disease were common; one of the causes may be a partial change to Western food. Recent studies by scientists from the Emory University Medical School have shown "that the incidence of cancer [among Inuit] has increased significantly following westernization."

Dr M Inoue, et al published in 1995 an investigation of cancers at several colorectal subsites: ascending, transverse, descending, sigmoid, andrectum, within a Japanese hospital environment. They concluded that loose or soft faeces are a significant risk factor for cancer at these sites.

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Abstract

To investigate the subsite-specific risk factors for colorectal cancer, we conducted a case-control study, using a common questionnaire which inquired about general lifestyles over the past five years (1988-92), at the Aichi Cancer Center Hospital, Nagoya, Japan. This study compared 432 patients with histopathologically diagnosed colorectal cancer (94 proximal colon [cecum, ascending colon, transverse colon]; 137 distal colon [descending colon, sigmoid colon]; 201 rectum [rectosigmoid, rectum]); and 31,782 first-visit outpatient controls who were free from cancer. In both genders, habitual smoking selectively increased the risk for rectum cancer. Soft or loose feces increased the risk for all subsites of colorectal cancer, particularly in female rectum cancer (odds ratio [OR] = 4.5). Among female dietary habits, Japanese-style foods decreased the risk for distal colon cancer, but increased the risk for proximal colon cancer. These results suggested that the risk factors for colorectal cancer differ by subsite among such a low-risk population as the Japanese. It is suggested also that 'irritable bowel' (soft or loose feces) might be associated with distal subsites of colorectal cancer, independently or combined with habitual smoking.

Abstract

CONTEXT:

Some epidemiologic studies suggest that elevated fruit and vegetable consumption is associated with a reduced risk of breast cancer. However, most have been case-control studies in which recall and selection bias may influence the results. Additionally, publication bias may have influenced the literature on associations for specific fruit and vegetable subgroups.

OBJECTIVE:

To examine the association between breast cancer and total and specific fruit and vegetable group intakes using standardized exposure definitions.

DATA SOURCES/STUDY SELECTION:

Eight prospective studies that had at least 200 incident breast cancer cases, assessed usual dietaryintake, and completed a validation study of the diet assessment method or a closely related instrument were included in these analyses.

DATA EXTRACTION:

Using the primary data from each of the studies, we calculated study-specific relative risks (RRs) that were combined using a random-effects model.

DATA SYNTHESIS:

The studies included 7377 incident invasive breast cancer cases occurring among 351 825 women whose diet was analyzed at baseline. For comparisons of the highest vs lowest quartiles of intake, weak, nonsignificant associations were observed for total fruits (pooled multivariate RR, 0.93; 95% confidence interval [CI], 0.86-1.00; P for trend =.08), total vegetables (RR, 0.96; 95% CI, 0.89-1.04; P for trend =.54), and total fruits and vegetables (RR, 0.93; 95% CI, 0.86-1.00; P for trend =.12). No additional benefit was apparent in comparisons of the highest and lowest deciles of intake. No associations were observed for green leafy vegetables, 8 botanical groups, and 17 specific fruits and vegetables.

CONCLUSION:

These results suggest that fruit and vegetable consumption during adulthood is not significantly associated with reduced breast cancer risk.

Konrad Biesalski, a nutrition expert at the University Hohenheim in Stuttgart, also noted the counterintuitive reality that many of the nutrients implicated in protecting against cancer, such as vitamin A, folic acid, selenium, and zinc, for which we have been told to eat more fruits and vegetables, are not only more abundant in meat but are also more “bioavailable,” meaning that they are more easily absorbed by humans into the bloodstream when eaten in meat rather than in vegetables (Biesalski 2002).

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Abstract

Based on epidemiological studies it is assumed that meat, especially red meat, enhances risk for cancer, particularly of the colon, breast and prostate. Meat and meat products are important sources of protein, some micronutrients and fat. High fat intake has been blamed for correlation with different diseases, including cancer. Meat protein is reported to contribute to cancer formation. However, meat, including liver, is not only composed of fat and protein, it contains essential nutrients which appear exclusively in meat (vitamin A, vitamin B12) and micronutrients for which meat is the major source because of either high concentrations or better bioavailability (folate, selenium, zinc). In particular, vitamin A, folate and selenium are reported to be cancer-preventive, with respect to colon, breast and prostate cancer. Taken together, meat consists of a few, not clearly defined cancer-promoting and a lot of cancer-protecting factors. The latter can be optimized by a diet containing fruit and vegetables, which contain hundreds of more or less proven bioactive constituents, many of them showing antioxidative and anticarcinogenic effects in vitro.

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