Can Anti-Oxidants Actually Cause Cancer?

Apparently they can in smokers and in those at risk for lung cancer, according to some research. Here's the article from the National Cancer Institute:

http://www.cancer.gov/cancertopics/factsheet/prevention/antioxidants/print

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Reviewed: 07/28/2004

Antioxidants and Cancer Prevention: Fact Sheet Key Points Antioxidants protect cells from damage caused by unstable molecules known as free radicals (see Questions 1 and 3). Laboratory and animal research have shown that antioxidants help prevent the free radical damage that is associated with cancer. However, results from recent studies in people (clinical trials) are not consistent (see Question 2). Antioxidants are provided by a healthy diet that includes a variety of fruits and vegetables (see Question 4). What are antioxidants? Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to cancer. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals might otherwise cause. Examples of antioxidants include beta-carotene, lycopene, vitamins C, E, and A, and other substances. Can antioxidants prevent cancer? Considerable laboratory evidence from chemical, cell culture, and animal studies indicates that antioxidants may slow or possibly prevent the development of cancer. However, information from recent clinical trials is less clear. In recent years, large-scale, randomized clinical trials reached inconsistent conclusions. What was shown in previously published large-scale clinical trials? Five large-scale clinical trials published in the 1990s reached differing conclusions about the effect of antioxidants on cancer. The studies examined the effect of beta-carotene and other antioxidants on cancer in different patient groups. However, beta-carotene appeared to have different effects depending upon the patient population. The conclusions of each study are summarized below. The first large randomized trial on antioxidants and cancer risk was the Chinese Cancer Prevention Study, published in 1993. This trial investigated the effect of a combination of beta-carotene, vitamin E, and selenium on cancer in healthy Chinese men and women at high risk for gastric cancer. The study showed a combination of beta-carotene, vitamin E, and selenium significantly reduced incidence of both gastric cancer and cancer overall (1). A 1994 cancer prevention study entitled the Alpha-Tocopherol (vitamin E)/ Beta-Carotene Cancer Prevention Study (ATBC) demonstrated that lung cancer rates of Finnish male smokers increased significantly with beta-carotene and were not affected by vitamin E (2). Another 1994 study, the Beta-Carotene and Retinol (vitamin A) Efficacy Trial (CARET), also demonstrated a possible increase in lung cancer associated with antioxidants (3). The 1996 Physicians’ Health Study I (PHS) found no change in cancer rates associated with beta-carotene and aspirin taken by U.S. male physicians (4). The 1999 Women's Health Study (WHS) tested effects of vitamin E and beta-carotene in the prevention of cancer and cardiovascular disease among women age 45 years or older. Among apparently healthy women, there was no benefit or harm from beta-carotene supplementation. Investigation of the effect of vitamin E is ongoing (5). Are antioxidants under investigation in current large-scale clinical trials? Three large-scale clinical trials continue to investigate the effect of antioxidants on cancer. The objective of each of these studies is described below. More information about clinical trials can be obtained using http://www.cancer.gov/clinicaltrials, http://www.clinicaltrials.gov, or the RePORT Expenditures and Results (RePORTER) query tool at http://projectreporter.nih.gov/reporter.cfm on the Internet. The Women’s Health Study (WHS) is currently evaluating the effect of vitamin E in the primary prevention of cancer among U.S. female health professionals age 45 and older. The WHS is expected to conclude in August 2004. The Selenium and Vitamin E Cancer Prevention Trial (SELECT) is taking place in the United States, Puerto Rico, and Canada. SELECT is trying to find out if taking selenium and/or vitamin E supplements can prevent prostate cancer in men age 50 or older. The SELECT trial is expected to stop recruiting patients in May 2006. The Physicians' Health Study II (PHS II) is a follow up to the earlier clinical trial by the same name. The study is investigating the effects of vitamin E, C, and multivitamins on prostate cancer and total cancer incidence. The PHS II is expected to conclude in August 2007. Will the National Cancer Institute (NCI) continue to investigate the effect of beta-carotene on cancer? Given the unexpected results of ATBC and CARET, and the finding of no effect of beta-carotene in the PHS and WHS, NCI will follow the people who participated in these studies and will examine the long-term health effects of beta-carotene supplements. Post-trial follow-up has already been funded by NCI for CARET, ATBC, the Chinese Cancer Prevention Study, and the two smaller trials of skin cancer and colon polyps. Post-trial follow-up results have been published for ATBC, and as of July 2004 are in press for CARET and are in progress for the Chinese Cancer Prevention Study. How might antioxidants prevent cancer? Antioxidants neutralize free radicals as the natural by-product of normal cell processes. Free radicals are molecules with incomplete electron shells which make them more chemically reactive than those with complete electron shells. Exposure to various environmental factors, including tobacco smoke and radiation, can also lead to free radical formation. In humans, the most common form of free radicals is oxygen. When an oxygen molecule (O2) becomes electrically charged or “radicalized” it tries to steal electrons from other molecules, causing damage to the DNA and other molecules. Over time, such damage may become irreversible and lead to disease including cancer. Antioxidants are often described as “mopping up” free radicals, meaning they neutralize the electrical charge and prevent the free radical from taking electrons from other molecules. Which foods are rich in antioxidants? Antioxidants are abundant in fruits and vegetables, as well as in other foods including nuts, grains, and some meats, poultry, and fish. The list below describes food sources of common antioxidants. Beta-carotene is found in many foods that are orange in color, including sweet potatoes, carrots, cantaloupe, squash, apricots, pumpkin, and mangos. Some green, leafy vegetables, including collard greens, spinach, and kale, are also rich in beta-carotene. Lutein, best known for its association with healthy eyes, is abundant in green, leafy vegetables such as collard greens, spinach, and kale. Lycopene is a potent antioxidant found in tomatoes, watermelon, guava, papaya, apricots, pink grapefruit, blood oranges, and other foods. Estimates suggest 85 percent of American dietary intake of lycopene comes from tomatoes and tomato products. Selenium is a mineral, not an antioxidant nutrient. However, it is a component of antioxidant enzymes. Plant foods like rice and wheat are the major dietary sources of selenium in most countries. The amount of selenium in soil, which varies by region, determines the amount of selenium in the foods grown in that soil. Animals that eat grains or plants grown in selenium-rich soil have higher levels of selenium in their muscle. In the United States, meats and bread are common sources of dietary selenium. Brazil nuts also contain large quantities of selenium. Vitamin A is found in three main forms: retinol (Vitamin A1), 3,4-didehydroretinol (Vitamin A2), and 3-hydroxy-retinol (Vitamin A3). Foods rich in vitamin A include liver, sweet potatoes, carrots, milk, egg yolks, and mozzarella cheese. Vitamin C is also called ascorbic acid, and can be found in high abundance in many fruits and vegetables and is also found in cereals, beef, poultry, and fish. Vitamin E, also known as alpha-tocopherol, is found in almonds, in many oils including wheat germ, safflower, corn, and soybean oils, and is also found in mangos, nuts, broccoli, and other foods. Selected References Blot WJ, Li JY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993;85:1483–91. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effects of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029–35. Omenn GS, Goodman G, Thomquist M, et al. The beta-carotene and retinol efficacy trial (CARET) for chemoprevention of lung cancer in high risk populations: smokers and asbestos-exposed workers. Cancer Res 1994;54(7 Suppl):2038s–43s. Hennekens CH, Buring JE, Manson JE, Stampfer M, Rosner B, Cook NR, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996;334:1145–9. Lee IM, Cook NR, Manson JE. Beta-carotene supplementation and incidence of cancer and cardiovascular disease: Women’s Health Study. J Natl Cancer Inst 1999;91:2102–6. # # # Related NCI materials and Web pages: Cancer Causes and Risk Factors Home Page 1 (http://www.cancer.gov/cancertopics/prevention-genetics-causes/causes) Cancer Prevention Home Page 2 (http://www.cancer.gov/cancertopics/prevention-genetics-causes/prevention) How can we help? We offer comprehensive research-based information for patients and their families, health professionals, cancer researchers, advocates, and the public. Call NCI’s Cancer Information Service at 1–800–4–CANCER begin_of_the_skype_highlighting 1–800–4–CANCER end_of_the_skype_highlighting (1–800–422–6237 begin_of_the_skype_highlighting 1–800–422–6237 end_of_the_skype_highlighting) Visit us at http://www.cancer.gov or http://www.cancer.gov/espanol Chat using LiveHelp, NCI’s instant messaging service, at http://www.cancer.gov/livehelp E-mail us at cancergovstaff@mail.nih.gov Order publications at http://www.cancer.gov/publications or by calling 1–800–4–CANCER begin_of_the_skype_highlighting 1–800–4–CANCER end_of_the_skype_highlighting Get help with quitting smoking at 1–877–44U–QUIT begin_of_the_skype_highlighting 1–877–44U–QUIT end_of_the_skype_highlighting (1–877–448–7848 begin_of_the_skype_highlighting 1–877–448–7848 end_of_the_skype_highlighting) Glossary Terms antioxidant (AN-tee-OK-sih-dent) A substance that protects cells from the damage caused by free radicals (unstable molecules made by the process of oxidation during normal metabolism). Free radicals may play a part in cancer, heart disease, stroke, and other diseases of aging. Antioxidants include beta-carotene, lycopene, vitamins A, C, and E, and other natural and manufactured substances. ascorbic acid (uh-SKOR-bik A-sid) A nutrient that the body needs in small amounts to function and stay healthy. Ascorbic acid helps fight infections, heal wounds, and keep tissues healthy. It is an antioxidant that helps prevent cell damage caused by free radicals (highly reactive chemicals). Ascorbic acid is found in all fruits and vegetables, especially citrus fruits, strawberries, cantaloupe, green peppers, tomatoes, broccoli, leafy greens, and potatoes. It is water-soluble (can dissolve in water) and must be taken in every day. Ascorbic acid is being studied in the prevention and treatment of some types of cancer. Also called vitamin C. aspirin A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. beta carotene (BAY-tuh KAYR-uh-teen) A substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. The body can make vitamin A from beta carotene. Beta carotene is being studied in the prevention of some types of cancer. It is a type of antioxidant. cancer (KAN-ser) A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy. cardiovascular (KAR-dee-oh-VAS-kyoo-ler) Having to do with the heart and blood vessels. cell (sel) The individual unit that makes up the tissues of the body. All living things are made up of one or more cells. cell culture (SEL KUL-chur) The growth of microorganisms such as bacteria and yeast, or human, plant, or animal cells in the laboratory. Cell cultures may be used to diagnose infections, to test new drugs, and in research. clinical trial (KLIH-nih-kul TRY-ul) A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study. colon (KOH-lun) The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. DNA The molecules inside cells that carry genetic information and pass it from one generation to the next. Also called deoxyribonucleic acid. efficacy Effectiveness. In medicine, the ability of an intervention (for example, a drug or surgery) to produce the desired beneficial effect. enzyme (EN-zime) A protein that speeds up chemical reactions in the body. free radical A highly reactive chemical that often contains oxygen and is produced when molecules are split to give products that have unpaired electrons (a process called oxidation). Free radicals can damage important cellular molecules such as DNA or lipids or other parts of the cell. gastric cancer (GAS-trik KAN-ser) Cancer that forms in tissues lining the stomach. Also called stomach cancer. incidence The number of new cases of a disease diagnosed each year. liver (LIH-ver) A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. lung cancer (lung KAN-ser) Cancer that forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope. lycopene (LIE-kuh-peen) A red pigment found in tomatoes and some fruits. It is an antioxidant and may help prevent some types of cancer. mineral (MIH-neh-rul) In medicine, a mineral is a nutrient that is needed in small amounts to keep the body healthy. Mineral nutrients include the elements calcium, magnesium, and iron. molecule (MAH-leh-kyool) The smallest particle of a substance that has all of the physical and chemical properties of that substance. Molecules are made up of one or more atoms. If they contain more than one atom, the atoms can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. National Cancer Institute The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. The National Cancer Institute conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the National Cancer Institute Web site at http://www.cancer.gov. Also called NCI. NCI NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute. nutrient (NOO-tree-ent) A chemical compound (such as protein, fat, carbohydrate, vitamin, or mineral) contained in foods. These compounds are used by the body to function and grow. oxygen (OK-sih-jen) A colorless, odorless gas. It is needed for animal and plant life. Oxygen that is breathed in enters the blood from the lungs and travels to the tissues. physician (fih-ZIH-shun) Medical doctor. polyp (PAH-lip) A growth that protrudes from a mucous membrane. prostate cancer (PROS-tayt KAN-ser) Cancer that forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). Prostate cancer usually occurs in older men. radiation (RAY-dee-AY-shun) Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable). randomized clinical trial (RAN-duh-mized KLIH-nih-kul TRY-ul) A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. retinol (REH-tih-nol) A nutrient that the body needs in small amounts to function and stay healthy. Retinol helps in vision, bone growth, reproduction, growth of epithelium (cells that line the internal and external surfaces of the body), and fighting infections. It is fat-soluble (can dissolve in fats and oils). Retinol is found in liver, egg yolks, and whole milk dairy products from animals and in fish oils. It can also be made in the body from a substance found in some fruits and vegetables, such as cantaloupes, carrots, spinach, and sweet potatoes. Retinol is being studied in the prevention and treatment of some types of cancer. Also called vitamin A. selenium (suh-LEE-nee-um) A mineral that is needed by the body to stay healthy. It is being studied in the prevention and treatment of some types of cancer. Selenium is a type of antioxidant. soybean A product from a plant of Asian origin that produces beans used in many food products. Soybean contains isoflavones (estrogen-like substances) that are being studied for the prevention of cancer, hot flashes that occur with menopause, and osteoporosis (loss of bone density). Soybean in the diet may lower cholesterol levels and reduce the risk of heart disease. Also called Glycine max, soy, and soya. supplementation Adding nutrients to the diet. tobacco (tuh-BA-koh) A plant with leaves that have high levels of the addictive chemical nicotine. The leaves may be smoked (in cigarettes, cigars, and pipes), applied to the gums (as dipping and chewing tobacco), or inhaled (as snuff). Tobacco leaves also contain many cancer-causing chemicals, and tobacco use and exposure to secondhand tobacco smoke have been linked to many types of cancer and other diseases. The scientific name is Nicotiana tabacum. vitamin (VY-tuh-min) A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body’s fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E. vitamin A (VY-tuh-min …) A nutrient that the body needs in small amounts to function and stay healthy. Vitamin A helps in vision, bone growth, reproduction, growth of epithelium (cells that line the internal and external surfaces of the body), and fighting infections. It is fat-soluble (can dissolve in fats and oils). Vitamin A is found in liver, egg yolks, and whole milk dairy products from animals and in fish oils. It can also be made in the body from a substance found in some fruits and vegetables, such as cantaloupes, carrots, spinach, and sweet potatoes. Vitamin A is being studied in the prevention and treatment of some types of cancer. Also called retinol. vitamin C (VY-tuh-min…) A nutrient that the body needs in small amounts to function and stay healthy. Vitamin C helps fight infections, heal wounds, and keep tissues healthy. It is an antioxidant that helps prevent cell damage caused by free radicals (highly reactive chemicals). Vitamin C is found in all fruits and vegetables, especially citrus fruits, strawberries, cantaloupe, green peppers, tomatoes, broccoli, leafy greens, and potatoes. It is water-soluble (can dissolve in water) and must be taken in every day. Vitamin C is being studied in the prevention and treatment of some types of cancer. Also called ascorbic acid. vitamin E (VY-tuh-min ...) A nutrient that the body needs in small amounts to function and stay healthy. Vitamin E helps prevent cell damage caused by free radicals (highly reactive chemicals). It is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy vegetables, and vegetable oils. Not enough vitamin E can result in infertility (the inability to produce children). It is being studied in the prevention and treatment of some types of cancer. Vitamin E is a type of antioxidant. Table of Links 1 http://www.cancer.gov/cancertopics/prevention-genetics-causes/causes 2 http://www.cancer.gov/cancertopics/prevention-genetics-causes/prevention

Dry Cleaning Chemical 'Likely' Causes Cancer

National Academy of Sciences Panel Agrees With EPA Analysis of the Risks of PERC

By Daniel J. DeNoon
WebMD Health News

Reviewed by Louise Chang, MD

Feb. 9, 2010 - PERC really is a "likely human carcinogen," the National Academy of Sciences says.

PERC is a chemical known as perchloroethylene or tetrachloroethylene. It's the solvent used by about 85% of U.S. dry cleaners, but is also used as a metal degreaser and in the production of many other chemicals.

PERC is found in the air, in drinking water, and in soil. It can be detected in most people's blood, as well as in breast milk. What's the risk?

In 2008, the Environmental Protection Agency (EPA) suggested that PERC be classified as a "likely human carcinogen." Moreover, the EPA found that PERC's most dangerous noncancer toxicity is brain and nervous system damage -- and set safe exposure levels well below levels that cause such damage.

But rather than finalize the ruling, the EPA asked the prestigious National Academy of Sciences to review it's PERC risk analysis and to tell the EPA if it's system for analyzing chemical risk was correct.

Now the expert panel appointed by the National Academy of Sciences says the EPA was basically correct. The panel agreed that:

• PERC is a "likely human carcinogen." This means that while there's no definitive proof that the chemical causes cancer in humans, there's strong evidence it does -- and there's proof that the chemical causes various cancers in animals.
• PERC's most dangerous noncancer effect is nerve and brain damage. Safe exposure levels for drinking water and air quality should be set well above levels that can cause such damage.
• The EPA's system for evaluating chemical risk is basically sound, although procedures for evaluating the strength of relevant studies need to be strengthened.

"We praised the EPA for doing a very thorough job," panel member Ivan Rusyn, MD, PhD, a toxicologist at the University of North Carolina, tells WebMD. "The overwhelming opinion of the committee was that the EPA was correct."

The major complaint the committee had with the EPA was that it put too much emphasis on a single study in setting the safe concentration level. That level is calculated by finding the highest dose that does no harm and dividing that dose by 1,000 or more to err on the side of safety.

The EPA suggested that a safe PERC concentration would be 2 parts per billion. The National Academy of Sciences committee used several different studies to calculate a slightly higher safe level, between 6 and 50 parts per billion.

"This is an immaterial difference," Rusyn says.

The National Academy of Sciences panel ruled only on the science used by the EPA and did not offer any policy advice on the use of PERC by dry cleaners or other industries. Such policies are for the EPA, Congress, and the states to decide.

California, for example, in December 2007 passed a law that will outlaw the use of PERC in that state by the year 2023. The California law also requires removal of all dry cleaning machines 15 years old or older by July 1, 2010. As of July, no PERC machines may be used in buildings shared with California residences.

PERC is not the same chemical as perchlorate, a different environmental contaminant used in products such as rocket fuel and fireworks.

The Halogenated Solvents Industry Alliance Inc., a chemical industry group that has criticized the EPA's draft assessment of PERC, was unable to respond to WebMD's request for an interview in time for publication.

from: http://www.webmd.com/cancer/news/20100209/dry-cleaning-chemical-likely-causes-cancer?ecd=wnl_can_021610