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Talk by Professor Jane Plant The Association Of General Practitioners Annual General Meeting
I wish to introduce to you Professor Jane Plant, who is from London, and who is the chief scientist with the British Geological Survey. She is a very busy woman, and I asked her secretary for a CV one day and she sent it over by e-mail; and I thought that my own secretary had made 6 copies of it and in fact it is 6 pages long so that will give you some idea of the amount of work that she gets up to. She is a Freeman of the City of London (and at the same age as myself I am wondering what I am doing!!) and congratulations on that - that was an honour bestowed on her last year. What makes her very interesting to medical people is that she had metastatic carcinoma, and has had 5 operations. In the mid-eighties she contracted it while working in Canada, she noticed suddenly that she had a lump on her breast, a common finding unfortunately these days. She was leading a healthy lifestyle and she went through the usual medical procedures, which anybody can read in her book. She wrote a book recently, which has become quite well known, and it is called 'Your Life In Your Hands'. She can explain herself why she wrote the book because she is not a recognised author in the public sense but this book has created a lot of interest and she puts her 'cure', and I would say that she has effected a cure, down to her own personal knowledge of her science, background and looking at her desperate situation, which it was, at one stage. So ladies and gentlemen I would like you to give a big welcome to Professor Jane Plant. Professor Jane Plant: - I would like to start off by thanking Dr Pat Crowley and the Association of General Practitioners of Ireland very much for inviting me her. I first choose to come to Ireland to study when I was an undergraduate at Liverpool University and I did my thesis in Donegal and I have never passed up an opportunity to come back here, so I am delighted to be here. As Pat said, my story in many ways is very typical and in some ways you have often read these types of stories in the daily press. Somebody has had some type of cancer, in my case it was breast cancer, it just kept coming back and coming back. I had 5 operations, I had 35 radiotherapy treatments, I had my ovaries irradiated, I ended up having 12 chemotherapy treatments and really it wasn't until I made a radical change in my diet and my lifestyle that this lump that was in my neck, which was like half a boiled egg sticking out of my neck, totally disappeared and hasn't come back for more than 7 years. I have also helped 63 other woman who to the best of my knowledge are cancer free, and I am delighted to say that many people since they read my book have written to me and told me that they had been told they were incurably ill and now their cancers are gone. Really what I want to talk to you this morning is not the personal aspect of my story but the sort of science picture I've put together. I am not a biochemist but I am a geochemist and I was therefore able to fight my way through some of the scientific literature; so what I want to talk to you about this morning are two aspects of the book. The press has picked on the dairy aspect, I am going to be talking about that, but in fact there are seven food factors that I've put in my book and five lifestyle factors. The two aspects I want to talk to you about today are first of all why I think dairy is particularly implicated in breast and prostate cancer and secondly why I think that we must stop using chemicals in our environment. They're given the fancy name of endocrine disrupting chemicals, hormone disrupting chemicals, and why I want to argue very strongly why I would like to see the medical profession more engaged in saying what we should and should not do to our environment. So those are the two aspects that I want to talk to you about today. Well first of all what is my background, why do I feel that I have anything to say on this issue? Much of my career has been spent looking at environmental geochemistry in human health, and particularly in relation to potentially toxic elements for example arsenic. It's my team in the BGS that's presently working in Bangladesh that identified the problems of these awful skin lesions and gangrene of the foot etc. We were the people who tracked it down to the fact that there is very high arsenic in the water there. And also I have done work on deficiencies in the essential trace elements (could I have the next slide please) and just to show you one of the things that we have done in the UK and we are presently working with colleagues in Ireland, so we should do this for Ireland, is to make these sort of maps which show the distribution of potentially toxic elements, potentially essential elements and also radioactive substances and I know that there is a lady here who's particularly interested in those distributions, and we are trying with help from the British, American, Northern Irish and Southern Irish governments to try and do this work over Ireland which we think will be helpful to you here. Well as part of the result of that work which started off in metalifous mineral exploration I got to know an awful lot of vets in the first place because they found that they could explain a lot of the diseases in their animals by looking at those sorts of maps. But then this developed as I said to work in developing countries, and I have already mentioned the arsenic problem to you, but one of the other problems that I have been very involved with is the distribution of 2 diseases in China; one called Cashand disease where children as young as 12 years old were dying of heart disease and Cashinbeck disease with is a very nasty form of, it is called arthritis, but is actually a very nasty distortion of the cartilage. And the Chinese a long time ago suggested this was due quite simply to low selenium in the grains that people were eating. Initially this was regarded as absolute nonsense by the British medical establishment until the famous Rout Institute in Aberdeen were able to reproduce the effects of low selenium on the hearts of experimental animals. Effectively the control animals and experimental animals were kept on identical diets except ones for the experimental animals lacked a few parts per million of selenium. After a few months when the animals were slaughtered the hearts of the selenium deficient animals looked like this. They were enlarged, the coronary artery and the muscles around them have all gone rather white and the most dramatic thing of all was when we put the hearts of the high selenium status animals into an ultrasonic machine they bounced around like a rubber ball; the ones from the selenium deficient animals just flew apart as if they were just made of paper. Again looking at the problem of selenium deficiency, it is now thought to be compounded by iodine deficiency both those Chinese ladies on the left are the same age one on your far left has got Casinbeck disease which is now thought to be selenium, iodine and also possibly a micro-organism is implicated. Of course you can have too much of a bad thing and in parts of China they have selenium toxicity. But what all this type of work had taught me is that there is usually a rational cause and that if you can it and if you can eliminate it then that is the way to deal with these sorts of environmental problems. But I'd kept this sort of knowledge locked away in one compartment of my brain as I went through all this treatment and it really wasn't until perhaps the 11¾ hour for me that I decided to think for myself and see if there was anything to do to help myself. When I had been out in China I was aware that they'd done a lot of epidemiological surveys, and they were aware that I was very interested in this, and they very kindly presented me with an atlas of the mortality in the Peoples Republic of China and they show the distribution of a lot of different cancers for example. This shows nasal frengal cancer, which is particularly concentrated in South China, (could I have the next slide please), which shows a completely different distribution of course to cervical cancer (could I have the next slide please). But if we now turn to the main topic that I am talking about which is breast cancer, I am going to show you in a minute the Chinese data, but I just want to say what has been happening in most western countries is that there has been a gradual increase in the incidence of both breast cancer in women and prostate cancer in men. OK some of it might be due to early detection but that is now levelling out and I think that most people agree that there is a percentage increase year on year in both breast and prostate cancer over and above that which is due to improved diagnosis. So going back to those maps of China, and this is the map that I had forgotten until I became very ill, this shows the breast cancer data from that same atlas, (could I have the next slide please), and can I now show you the scale on that because of many of you will know that in most western countries about one in ten women (assuming a lifetime of 85 years) is likely to get breast cancer. The background rate on this map you can see is between 1 and 2 per 100,000. Now I am aware that's a rural rate, and I am aware that it is a younger population (could I have the next slide please) but even when you take the age standardised rates of incidence from IRAC who can still see that there is still a very dramatic difference between rural China where people live on a traditional diet and it gradually increases into the urban centres, it is about the same rate in Japan in their urban centres and interesting Hiroshima and Nagasaki are about the same level as other urban centres and then it increases quite dramatically when you start to look at any western countries, and of course it is particularly in the USA, and it is particularly high in the richest communities in the richest parts of the USA when the incidence is about one in eight and rising I am told. Again prostate cancer shows a very very similar sort of distribution. So the conclusion that you can draw from that is that if you were an American white person, and even if you went to live in irradiated polluted Hiroshima and lived a Japanese lifestyle you are going to cut your risk of breast or prostate cancer. Again using the World Health Organisation mortality rates, we can see, really since reliable data began to be collected, and I may say these have validated by people like Richard Peters Group from Oxford, and Professor Campbell from Cornell University working with Trandon Che from Beijing and it is not an artefact of the data I do not think, you can see that countries who live a traditional eastern lifestyle tend to have much lower rates of breast cancer in a completely grouping in terms of mortality to those of us who lead a western lifestyle and as you move to a more urban type of situation like Hong Kong where there's more western influence the mortality rate increases and also Japan as it is becoming increasingly westernised the rates have increased. Well I am now going to go through what some of my thought processes were in dealing with my own breast cancer once I'd got a grip and stopped panicking and rushing around and well just giving up I suppose. I think that the first thing to say is that following Professor Doyle's absolutely pioneering work that there's a rational explanation of cause and effect now accepted for many types of cancer, it is not visited upon us by a wrathful god or just faulty genes, there's often a very well known cause and effect relationship known for many types of cancer and I have listed some of them there. Obviously some people are more likely to be effected because of there genetic make-up and we are getting to know more and more about that and I'll come back to that at the end. As I have said, breast cancer incidence in the west e.g. the eastern USA, which includes many ethnic groups has a breast cancer incidence similar to the lung cancer incidence amongst heavy smokers i.e. about 1 in 8 people will be effected. Oriental countries, it's well known has traditionally had very low breast and prostate cancer rates, but migration studies show that when they move to the west those rates approach those of the host community. That has been shown in Australia, Canada, the USA, New Zealand, and indeed in Europe. Breast and prostate cancer rates also increase when oriental people adopt western lifestyles and in China the slang name for breast cancer is 'rich woman's disease'. Anybody who has worked in China as I have, will know the Chinese people will eat almost anything but they will not eat dairy produce. Traditionally if you offer them with dairy in some of them will almost recoil. So the fact that they do not eat this is quite surprising because they eat sea slugs and chopped up ducks feet and linings of shark stomach - you name it they will eat it. The consumption of western food is increasing in oriental countries with development, and westernisation traditionally begins in urban centres and where they have significant and rising rates of breast and prostate cancer than rural areas. Now I've read a lot of genetics and there is quite a lot in my book, and one of the things that is encouraging about breast cancer is that the genetic studies and the monocular protein studies of breast cancer indicated that whatever's gone wrong, the genes have become mutated and started to produce either the wrong amount of proteins or the wrong types of proteins are at the level of receptors and intercellular fluids so they are either the receptors for the 'don't grow' message or they are the receptors for the 'grow' message that have gone wrong so they are not proteins that are deep in the cell as is the case for some of the more intractable types of cancer. Now, as far as we know only 5 to 10% of breast in cancer result in inherited mutated tumour suppresser genes and even those who have those mutated genes don't always develop breast cancer. So it suggests that you can still perhaps help yourself even if you have inherited those bad genes. Now, at the time that I cottoned on to this eastern idea that the Chinese were doing something right and I was doing something wrong, I went through the known theories on this - one was that it was the low fat diet that helped the Chinese, but I was having an incredibly low fat diet. I was screening everything to make sure that it was low fat so in my case that just did not add up. I was aware of the soya hypothesis that the isoflavins and phetooestrogens in soya were protective; but again I was having a lot of soya everyday so that did not add up. And my husband and I, both of us have worked in the east a lot, were brainstorming this and we can't remember which one of us said they don't have a dairy industry, they don't have dairy produce, and suddenly a lot of things fell into place. I was reminded of the Chinese saying milk was just for babies and then it was using wet nurses, it certainly wasn't from another species. I was reminded of one occasion when our wonderful foreign office advised us that the Chinese loved ice cream and we had a Chinese delegation visiting us and when they asked what the pudding was and we told them they refused to a person to touch it. And so I thought well, you know, I had been eating a couple of organic really low fat yoghurts a day on my doctors advice because I was finishing off my chemotherapy and this was to repopulate my gut. So I stopped having dairy produce, I was already on a pretty healthy diet with lots of fruit and vegetables, juices all the other things that I have talked about in my book and to my amazement, and it certainly wasn't because I was thinking positively, within a week this lump started to itch, and I was plotting it's size as I had plotted all my lumps (this is my being a scientist) with a sort of callipers most people use to measure fossils so that you can lock them into position, get an accurate reading, and this lump just disappeared off the bottom of the graph within 5 weeks and has never come back and it is now 7 years on. So I have ended up variously treating about 63 other ladies all of whom, to the best of my knowledge, have never had any recurrence of breast cancer. Those who for various reasons said that they did not want to listen to me about my diet, and it is not just give up dairy, there are 7 food factors in the book; the 6 who said that this was nonsense for a range of reasons 5 of them sadly have died and one is now very seriously ill. I know that's is observational; I know it's not statistical and I wouldn't have published the book but I did want to know why does this work? is there any evidence that suggests that as well as the epidemiological evidence any mechanistic explanation for my admittedly observational science. And what I came across was a lot of literature on a chemical called insulin-like growth factor 1 which occurs in milk and has been particularly the centre of attention as a result of the use of bovine growth hormone to increase milk production; a practise now banned certainly in Europe but which still goes on in America and we cannot ban the imports of American milk produce. So if we import any milk produce it is like to have exceptionally high levels of IGF-1, but all dairy does contain these growth factors like IGF-1 and what they are designed to do is when a newly-born animal leaves the mothers womb is to keep that development going, and in fact many cultures call milk 'white blood'. So I started to focus on this chemical and I found that there was a lot of evidence that the milk and meat of dead dairy animals contains significant growth factors and hormones such as prolactin. Originally I was concerned about oestrogen levels in milk but was persuaded that these were not a problem but I will come back to this later. Despite the fact of bovine growth hormone, there is evidence that levels of IGF-1 in milk have increased anyway due to selective stockbreeding and the adoption of high yielding species for dairying. As I said the use of the genetically engineered hormone forbidden in Europe increases IGF levels in milk to the top of the normal range. It's well known that IGF-1 and prolactin, which is also present in milk, promote breast and prostate cancer cells in laboratory cultures. There are many experiments that show that and breast tissue has receptors for IGF-1, IGF-2, and prolactin. There is research that shows that casein, which is the main milk protein, protects growth hormones in milk from breaking down in digestion and if you think about this, this is logical because if you are trying to get those growth hormones through to the blood of a neonate, a newly born animal, that would be a logical thing for nature to have done. There is some suggestion in the scientific literature, and I emphasise none of this is my own research, it is just from other peoples research I've just put it together, that modern milk processing may further protect chemicals from digestion increasing their absorption. I am turning now to the evidence that this actually does cause, or have a role in creating breast or prostate cancer, there is some very interesting prospective studies where people have kept blood samples and then followed up these people years later which shows that pre-menopausal women with high levels of circulating IGF-1 have a much higher breast cancer risk and men with high levels of IGF-1, at 8% are at an increased risk of prostate cancer. At the time that I wrote my book that was as far as I had gone but subsequently it's been shown by Oxford University, the epidemiology unit there, Imperial Cancer Research campaigns unit directed by the famous Sir Richard Peto that vegans have a lower level than IGF-1 by about 9% than vegetarians who consume milk or meat eaters who also consume milk. The point that I am going to come back to in the second part of the talk is milk is a major pathway by which carcinogenic and endocrine disturbing chemicals such as dioxins enter the body, so I think that it is not only a source but it's also a pathway of some other damaging chemicals. I just want to empathises that this totally new evidence that was released within a week of my book coming out, and anybody who has read it will know I said that a missing link in my theory was that nobody had showed that IGF-1 related to diet; there was a rather obscure paper I could find but that was all by Eric Underwood and Perdue, but the new evidence from Oxford showed that IGF-1 is 9% higher in those who are either omnivores or dairy consuming vegetarians than vegans, and according to June Chan's work you only need an 8% difference in IGF-1 levels to increase prostate cancer risk by 7 times. So I think that that is pretty compelling evidence coming from Oxford University, especially such an eminent group. And then I'm giving a talk to the Parliamentary Science Committee in the UK in November, and it's basically on manmade chemicals in the environment, and to my amazement I stumbled across this (table on slide). It was trying to say that perhaps it was not all manmade chemicals that were causing the problem. It was almost tucked away in the table at the back. It says that it is part of the roots of human exposure to oestrogens that have changed in the past half century; the Rural Society actually states increased consumption of dairy produce and says that dairy practice says changed such that pregnant cows which produce high levels of oestrogen continue to be milked. Significant levels of congregated oestrogens are therefore present in cows' milk. The extent to which these are activated in the human gut and how much oestrogen the consumer is exposed to is largely unknown. Well many of us who have worked on the environment know of Professor John… (Tape goes blank for a few minutes) …which is taken in through various dietary products and you can see that dairy is highest followed by beef and then quite a marked decline to pork and chicken, then comes fish and eggs and then other, so if you are on a vegan diet (other) means that the intake of dioxins would be considerably lower. Well I'm going to turn now to endocrine disrupting chemicals and just talk about what these are. The old definition of EDCs is that they are synthetic or natural chemicals that upset the balance of the complicated endocrinal hormone system. They are particularly persistent in the environment, they can start of in a landfill in India, and end up at the Pole because they are very persistent and they tend to get carried around the globe in a way that we cannot predict as environmental scientists. And they have great chemical stability and high fat solubility. That was the old definition, and increasingly it is realised that metals such as lead can have this effect, and of course IGF-1 and IGF-2, which have these effects, are both peptides, so they are proteins, so this emphasis that used to be on fat solubility is diminishing. We have known for a very time that these things cause problems to other species and this is from a recent report from the European Environment Agency called Chemicals In The Environment, Low Dosages High Stakes and you can see that things like DDT have long been known to have a very significant association with the disruption particularly of reproduction in a whole load of species. This is to show one example of a particularly nasty endocrine disrupter that the Royal Navy is still allowed to use, tributyl 10. At levels of parts per trillion this has an impact on particularly whelks and certain animals related to them whereby the females grow male organs that totally block their egg tubes and these animals die. Some of you would have seen recent reports on the press about tributyl 10 being used as preservatives on other things imported into the UK and as I say it is a particularly nasty endocrine disrupter. Just to show, many of you will know the method where DDE the main metabolite from DDT effects wildlife; and why we thought that this shouldn't affect us I don't know. It is of course a banned chemical. When Rachel Carson first wrote her first book, 'Silent Spring' she was regarded as a lunatic and a heretic and since then all the chemicals she named have been banned and are illegal in developed countries. Just to run through some of these endocrine-disrupting chemicals. These are some of the pesticides that were used - many now banned - many we don't know where on earth they are in the environment. Just to mention Lindane in the context of breast cancer, there was a very significant cluster of in Lincolnshire and this has now been attributed to the fact that Lindane was being used on sugar beet, the sugar beet tops were being chopped off, fed to the cows. These chemicals tend to bio-acuminate up the food chain, so you can start off with low levels and they reach higher and higher levels becoming particularly concentrated in things like milk…(end of tape, continues on side B)…more pesticides which are intentionally used, at the moment these are all permitted ones; I wonder how long it will be before we decide to find that there are problems with these too. Two herbicides Atrozine and Simozine used a great deal on maize interestingly they are banned from non-agricultural use and yet they are allowed to be used on our food. This just shows pesticide use in 1995, this industry has a global value of 30 US billion dollars a year, and you can see that in which of Western Europe we allow quite a lot of pesticides to be used. Many have been banned that were formerly used and we still have lurking around in our environment, and we tend to use them in Western Europe and in the USA at levels which are in order of magnitude greater than they're used elsewhere in the world. Interestingly some of the people who are coming up with genetically modified organisms, they are not making genetically modified organisms that replace pesticides, they are coming up with ones that can withstand pesticides, and I wonder if it's because those same companies produce both products - but perhaps I am being too cynical. Some of the other substances; I can remember using PCB as this wonderful thing for the microscope to examine slides, and then people appeared dressed as if they were ready to go for a lunar landing to remove these things because they were so toxic. And again inadequate risk assessment had been done, and again these things are really very dangerous. And dioxins and florins of course form particularly be burning plastics, particularly PVCs which many of you as medics will use a lot introduce quite a lot of dioxins into the environment. Again very nasty endocrine disrupting chemicals and carcinogens in their own right. Again a lot of detergents are known to have endocrine disrupting chemicals. And just to show the extent to which, in Europe at least, chemical industry production is actually outstripping GDP so there's no question that the use of these is decline - it is increasing and it's outstripping GDP. (Could I have the next slide please) Finally I'll mention that you can have endocrine disrupting chemicals which are natural. Of course the contraceptive pill is now being picked up in water and as we recycle water more this is of concern, but also natural oestrogens from both females excreting normally including agricultural animals, and as I said tests on these inter-sex fish in the UK, I do not know whether you have any of them in Ireland, but where 100% of them male fish, if you look at a slide of their testicular material it's overgrown by eggs. It is now thought that as well as some of the endocrine disrupting chemicals it's partly the result of the fact that it's simply these types of oestrogen that are coming through in sewage works. As I said these effects are apparent at levels parts per trillion which is a very very low level, it is almost barely detectable. So this is also of concern. I went out work in Japan and Canada, nothing to do with breast cancer at all; I was going out there in connection with my normal work to look at methods of looking as oestrogenisty of chemicals in the environment and to my great amazement I found that what they have developed there, and what we are now using in this country, was that they were using the MCF-7 line of breast cancer cells, which many of you will know is very oestrogen dependent. They genetically modified it by adding a luciferase gene which is luminescent in a dose dependant way and they were testing a whole range of chemicals on the basis of using this modified breast cancer cell culture which I was very surprised about but obviously I think that it has great implications for what I am saying. And can see from that that oestrodial itself produces a pretty dramatic dose dependant response using that particular breast cancer cell line; and it's in nanomolar concentrations so it is very low concentrations and you can also see that DDT produces a dose dependant response; biphenyl's, I mentioned PCBs from the electrical transformer industry, produces a pretty dramatic dose dependent response as does bispenyl-A which is often used as a plastic coating; even on the inside of tinned food. So all those things produce a pretty dramatic response and just to show you dioxin does this too, (but it is also a primary carcinogen) and you can see that in liver cancer cells you get a pretty clear dose dependent response again at extremely low levels; so dioxin works on two levels. Well the message from that: The first part, the dairy produce and some of the other foods that I have implicated in my book, there is something that we can do about that; but in the case of chemicals that we put into our environment, endocrine disrupting chemicals, it is very difficult to do anything about that as an individual. You can buy organically grown food, you can grow your own, but there is a lot of evidence that even that is becoming cross-contaminated. The only thing that we can do is, as a society, try to cut down those chemicals and I particularly appeal to you as the medical profession to become involved in monitoring this. When we hear of organophosphates causing syndromes, don't lets dismiss it, don't lets say these people are cranky. As somebody who has worked on the environment, if these chemicals are causing problems to many other species, I think we should the precautionary principle and say it is likely that they are going to cause harm to us. And finally I would just like to turn to this painting to show that Rembrandt, who was a very brilliant painter painting in the early part of the 17th century, painted his mistress in this painting, and you can see quite clearly a large lump in her left breast and I think many medics have concluded that that breast cancer and of course it's known that breast cancer has been with us a long time, before we put a lot of these manmade chemicals into the environment. The rates have increased. Some of that may be the manmade chemicals but I still feel that it is our western diet with a high dependence on animal products and especially on dairy products. But obviously it's one in ten of us that are affected and they are may be nine people out of ten who can eat dairy produce and have no ill-effect at all, and I think that the way forward is with an alliance with people who are working on environmental factors and those who are working on genetic factors. At the moment there's a bit of a 'yaboo' culture between the two, one saying that it is all genetics and the other saying no it is all environment. I think what is like to emerge is that there are carriers of mutated genes who are more vulnerable either to consuming dairy produce or to endocrine disrupting chemicals in the environment and what we really need is a holistic approach of those two groups of scientists working together. Thank you very much. Dr Patrick Crowley: Thank you very much Jane. I'm sure that everybody is better informed now after listening to Jane, and I'd like to ask for question from the floor for ten or fifteen minutes and I have a roving mic' if you want to talk into it. (1st question not audible) Question from audience from Mary F Grehen: A few years ago the World Health Organisation that you were referring to were issuing a statement where they suggested breast feeding should be discontinued or should only be carried on for a very short time in the developed world because of the high concentration of dioxin in breast milk; and the decision was made instead to actually move the goal posts and to if you like allow the acceptable levels to increase, this famous word 'acceptable' levels, on the grounds children, by the time they reached 10, the actual levels of dioxin in their bodies would be reduced in proportion to their body size. Have you have any comments on that? Reply from Professor Plant: Well I think that that is what legislators always do. Anybody you saw the programme on BBC about mad cow disease and the fact that the scientists had frankly allowed themselves to be used as a load of patsies and just say what the government wanted them to say - a most staggering thing - that they were prepared to say 'there is no evidence that…' and that statement is now something that the British public almost laugh at now. If a government scientist says Question from a reader in the audience: I read your book some months ago and I was very struck by it. I do have one or two questions. First of all, the fyto-oestrogens - can you comment a little bit more on the possibility that these would in fact increase your oestrogen levels because it is affirmed a little bit in me now since your talk when you mentioned the oestrons and oestrodials are in fact increased in their levels both naturally and with a high intake of soya. Could you comment on that please? Reply from Professor Plant: Yes well the epidemiological evidence is quite clear that soya appears to be protective. There are several reviews on soya and fyto-oestrogens in general. I've put on in my book, which was a review paper on fyto-oestrogens; it was the isoflavins, the lignals and the cormostans and there is evidence of course that if you have really really high levels of these they can cause problems. I mean the first discovery of my reading of the subject about fyto-oestrogenisty was when she developed some problems I think it was in Australia. But I don't think the levels of soya that one would have to replace dairy in your diet are going to cause any problem. I can only say that I have done it for 7 years and I have not had any problem and the 63 other women that I know closely haven't had any problem and the number of people who are writing me - I mean I was saying only last Friday two ladies who'd been told that they were terminally ill contacted me to say that all trace of their cancer had gone and two men who'd had inoperable prostate cancer phoned me to say they were completely better so I can only say that observationally I can not see a problem. And with fyto-oestrogens, I mean, for some reason it has got totally latched on to soya, it is worth remembering cows milk contains fyto-oestrogens anyway, but a bowl of strawberries, a bowl of blueberries, a bowl of cranberries all contain fyto-oestrogens. Lots of grains and lots of nuts contain fyto-oestrogens and for some reason these seem to be protective. The overwhelm evidence in reviews by Adelcruts for example who did a very thorough review for the European Union, (and I recommend that to you, it wasn't in my original book, it will be in the American version), the overwhelm conclusion and of the latest Royal Society report is that these are protective. But obviously I am not advocating that you live totally on soya. I keep quoting what people in Scotland tell me ' Moderation in all things, especially in moderation', and that comes into their whiskey drinking; so I'm not saying live totally on soya, I'm saying live a balanced diet. I have given you seven food factors in the book, and some simple changes everybody can make and so that's the pitch, not to just live totally one just one-food substance. The Japanese, it is very interesting, they believe that you haven't had a healthy diet unless you have had twenty-seven different things everyday. So I hope that that answers your question. Question in the audience from the Senior Nutritionist in the National Dairy Council: Comment from Professor Plant: I'm sorry; it is not a single case history. Continuation by Senior Nutritionist in the National Dairy Council: Well I know that you have mentioned that you have given the advice to several other women as well, but I think that if you look at the balance of evidence in the literature, there was a review done 1998 on epidemiological studies which showed that there were twice as many studies showing a protective effect for dairy in breast cancer as there was showing a negative, and the gold standard in terms of research would be prospective co-hertz studies and just last year Holmes and * in '99 published research from the nurses health study which showed that there was improved survival from breast cancer, 2 000 women, in those who eat more dairy, poultry, and fish. So if we practise evidence based medicine we need to look at the literature and give women advice based on research that is founded as opposed to stuff that has been peer reviewed. And the question that I wanted to ask was … Senior Nutritionist in the National Dairy Council: Well from our own review of the literature which is something that we keep a close eye on as well, the balance of evidence would say that there is no link and what I wanted to ask you was is it not dangerous to give women advice on this when it is really an emotive issue and we don't have scientific evidence to back it up when in actual fact you may be asking women to follow an imbalanced diet. People have mentioned soya and natural soya milk only contains 10% of the amount of calcium as cows' milk. Comment from Professor Plant: Where do cows get their calcium from? Where do cows or hippopotamus get their calcium from? Senior Nutritionist in the National Dairy Council: What I'm actually saying is - we are talking about humans. Comment from Professor Plant: You do not need dairy to get calcium. Senior Nutritionist in the National Dairy Council: We are talking about humans. And I am talking about women that you have given this advice to, and Irish women get almost 60% of their calcium from cows' milk, and it is important in the prevention of osteoporosis which affect 1 in4 women in Ireland. The calcium in fortified soya milk isn't absorbed as well that of cows milk. The only point that I wanted to make was that the balance of evidence in the literature that we reviewed does not support this. There is actually studies which show that consuming more dairy actually helps survival in breast cancer, and you are giving women advice that isn't backed up and may be actually putting them at risk of other conditions such as osteoporosis. Comment from Professor Plant: Can I say that I have dealt with the issue of osteoporosis at some length in the book. And I have only helped one of my friends who had osteoporosis who has gone on my diet and she had a spontaneous fracture of the hip. She went on my diet. She recently went for check-ups and her doctors couldn't understand why her blood chemistry is now normal. So you don't need to have dairy to get calcium. Hippopotamus are pretty robust animals, so are great apes, in my view it is completely unnatural for adult people to obtain their food by suckling the adult female of another species. I watch a lot of David Attenborough programmes, I have yet to see an adult animal of any species go and suckle the adult animal of another species to get their sustenance. I've seen them eat eggs of other species; I've seen them eat flesh of other species: I've seen them eat lots of vegetable material; I have never seen that. The cow was first domesticated only 8 000 years ago which is a very short time in human evolution, yet along mammalian evolution and although some people may be able to cope with it I believe that there are individuals who can't. And many of the references from my book are from the peer-reviewed literature. And I think that people from the Royal Society, headed by people like Professor Bateson from Cambridge - he wouldn't put a statement like that about oestrogens in milk in lightly. Senior Nutritionist in the National Dairy Council: Well I just think we are not talking here about hippopotamus and other species, we are talking about women and Connie Weaver in the States, who does a lot of work on how vegetarians get their calcium and vegans, has shown that it is very difficult - it is hard work. For example you would need 16 servings of spinach to match the calcium in a pot of yoghurt. So for most women it is much easier to get their three servings of milk a day to get their calcium, and most of us need milk to get calcium and prevent osteoporosis. Comment from Professor Plant: I don't believe that, I think that it's propaganda. (Applause from the floor). Dr Pat Crowley: Now we can have a few more questions and then we'll have to close for lunch. From the audience: Thank you Professor Plant. I enjoyed your rebuttal and completely agree with you on the osteoporosis story. I want to comment briefly on the previous lady if you might to add to what you said on fyto-oestrogens. There is evidence that in fact that as the metabolism of the oestrodial and the oestrones as well in the body; it's the formation of 16 hydroximetabolites of the oestrones that protective and so by taking fyto-oestrogens we encourage the oestrogen metabolites down this pathway of these 16 hydroximetabolites and by doing that it is actually protective in the breast cancer situation and there is evidence to support this. So I just wanted to add this to what you said because I think that it might interest you. (Professor Plant: Thank you very much.) Also I enjoyed your talk but I came in little late, and for that I apologise as we came very far, but I wonder if you mentioned earlier about the wearing of a bra and any association with breast cancer, and I wonder would you like to comment on that please. Comment from Professor Plant: I personally don't think that wearing bras one-way or the other has much of an effect. I know that there was one book out lately that said that if people wear tight ill-fitting bras it can cause problems. But I mean that it would be too painful - I just don't believe that most middle-classed women would go around wearing bras that were so tight and ill fitting that it would cause breast cancer. I just wear standard 'Marks and Sparks' bras and I don't think that it is a cause but I don't really know whether there is any evidence on that one way or the other. Probably because my background is in environmental chemistry that tends to be where I look, so as a scientist I have to have a rational explanation for something. To me diet, the epidemiological and the mechanistic data tends to me to point to diets and chemicals in the environment. Dr Pat Crowley: Last question now. Comment from Mary F Grehan: I think I'd take my chances any day with osteoporosis over cancer of the breast thank you very much. Comment from Professor Plant: But you won't get osteoporosis. I wish you could see my fingernails. When I used to live a typical western diet I couldn't grow my fingernails at all and I was always having joint problems and things. Since I've been on my diet, I've lived on it now for more than 7 years; I've hardly had a day's illness. One of the gentlemen that phoned me on Friday to say his prostate cancer had gone, he said that he had climbed a mountain that he hadn't climbed since he was 26, and this was 6 weeks after finishing his radiotherapy and this man is 75. I am an observational scientist and all my observations tell me that there is something in this. Comment from Mary F Grehen: it is just something that we are noticing, and I've maintained that general practitioners tend to see things before they get into the public domain. We are noticing at the moment when we are doing routine hormone test for woman before they go on hormone replacement therapy that our prolactin levels are high in about 1 in 10 to 12. We have no explanation for it, but we are noticing this. A comment that one of my secretaries made recently was, and again it is a very interesting one, a lot of the male patients coming in with infertility are all living along the riverbank, a tidal river quite close to us. If you think there is sewerage being dumped into this particular river and it is not treated. The other thing is we talk about papers and peer review and all the rest of it, if you look back on the history of smoking and cancer of the lung and you all at the early papers you can easily produce half-a-tonne of papers that say smoking is safe and dos not produce cancer. We have to look at them, we have to look at them carefully and we have to keep an open mind. Comment from Professor Plant: Have you read Simon Glance's book called the 'Cigarette Papers' because what he actually showed or what he claims in that book is that the industry had actually funded science to show that it was protective in order to obscure the issue and that is very worrying if that is going on. The British Medical Journal now asks any author to say where their funding source was from, and to state any conflict of interest. And in going through the work for my book I tried very very hard to make sure or try to look for where the funding might have come from. In the latest book that has gone into America, I did find some evidence that one study that came up with views I wouldn't agree with; Kradjian I think was the doctor who suggested that there had been funding from a particular food sector. I may say that approaches have been made to me to endorse various food products and I have said 'Absolutely not' and I'd like to point out that all the proceeds of my book I am putting into what I hope to turn into a charity. I've done it because I want to help people; I haven't done it to make money, and I haven't down it to endorse anybodies food products. I simply wanted to put the information I had as a scientist and make it available to other women. You can reach your own decision that is up to you but at least I feel I've done what I had to do in good conscience to share the information I had with other people. (Applause from the floor). Dr Pat Crowley: One last one. From the audience: I would like to thank you Jane, but I could I be so personal to ask - what do you eat. Professor Plant: What do I eat? I eat lots of things, I eat most things. I eat meat again now but as I said in the book I make sure that it is cooked the way my mum always insisted that I should cook it i.e. slowly and thoroughly. There is a tendency now to eat meat that's burnt on the outside and raw on the inside so that it is almost ready to get up and walk away and I don't do that. I eat masses of salads, masses of steamed vegetables, I do eat soya, I do eat fish, I do eat organic eggs, and I try and have organically produced food wherever I can. Most people coming to my house say 'oh I thought I was going to have a really weird lot of food' and they said that it was actually quite delicious. So no problems. I actually been asked to write a cookbook but as a scientist I am not sure that I am going to be able to do that, I think that it might be beyond my talents to do that, but still. Dr Pat Crowley: Thanks very much. I think now that we have explored the breast cancer issue with Professor Plant and I would like to thank her very profoundly for coming here. When I read the book I was struck immediately by the fact that it was significant in that we had an insight that seemed to be obvious to somebody who was living in China but was not obvious to us here. Now her own personal story is written in the book and the book is outside if people are interested in buying it and I am sure that Jane wouldn't mind signing a few of them if people want that. Dubray Books and Siobhan is around somewhere if people want to buy the book. As medics, what I am thinking since I have read the book, and it has provoked a change in my thinking, is that when I see patients with breast problems, cancer, other problems, breast pathology that I am immediately thinking that they should be informed of the knowledge that is in this book. They can make up their own minds. I've gone so far as to write to a young patient who has gone back to Canada, and who had breast cancer in her 30s to tell her that the book is available because I feel so strongly about this. Jane tells me that the book is not available yet in North America…. |
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Introduction by the AGP Chairman, Dr Patrick Crowley: -