Between Covers, an Anticancer Infomercial

By ABIGAIL ZUGER, M.D
07 oct 2008--The famous name and the impeccable scientific credentials don’t hurt, but David Servan-Schreiber’s “Anticancer” rides mostly on the sincerity of his pitch. It is worthy of the finest in nighttime television infomercials, where among all the financial advisers, kitchen gadget guys and acne specialists is one with a story so personal, heartfelt and sensible that you suddenly need exactly what he has to sell.
Not that Dr. Servan-Schreiber is peddling a product (other than his book). Rather, it is a way of life he wants you to buy into, a guide to staying cancer-free (or, if he has reached you too late, fighting off your cancer) by paying careful attention to what you eat and how you behave.
Like all the best pitchmen, he offers his own story of redemption as testament (he once was lost but now is found, was blind but now he sees). Son of the noted journalist and politician Jean-Jacques Servan-Schreiber, he left France for Montreal as a student, then went on to the University of Pittsburgh. There he embarked on a research career in psychiatry and neuroscience, cruising the city on a motorcycle, a young intellectual on top of the world.
Then one day a research subject failed to show up for a scheduled M.R.I. scan, and Dr. Servan-Schreiber took his place in the scanner. Utterly by happenstance, the scan showed a walnut-size brain tumor.
Unnerved but undaunted, Dr. Servan-Schreiber underwent the recommended surgery and returned to his usual routines. His life remained a high-stress, low-exercise affair; lunch was a bowl of chili, a bagel and can of Coke. Five years later the tumor recurred, and in the course of enduring a second surgery and a round of chemotherapy he saw the light: the red meat, white flour and soft drinks were going to help the cancer do him in. He had to detoxify his body.
Here his story segues smoothly into a lucid discussion of cancer immunobiology, in which the bad cells can be tamed by manipulations of their environment. And then we are in the kitchen, reviewing its contents from the specific perspective of cancer prevention.
This familiar terrain encompasses the antioxidants, the good fats, the whole grains and the green teas. There are the combinations essential to maintain (you must take your turmeric with pepper) and the ones to avoid (no milk with your dark chocolate). Cancer “feeds on sugar” but supposedly not on agave nectar; on omega-6 trans fats but not the omega-3s. The blanket of body fat in the obese creates a giant repository of fat-soluble carcinogens.
We hear the story of Lenny, who adopted a diet heavy on cabbage, berries and dark chocolate, and survived pancreatic cancer for an impressive four and a half years. We meet vegetable-fed mice, who seem more active and curious and have slower-growing tumors than their chow-fed brothers. And Dr. Servan-Schreiber himself, of course, is still doing well at age 47 — 14 years after his initial diagnosis.
For each of the foods on his anticancer shopping list there is a shred of scientific evidence — usually from experiments done on cells in culture, sometimes from studies of mice with cancer, and occasionally from small studies on actual human beings. For none is there the kind of data that would support, say, the licensing of a new drug.
Extracts of garlic, onions and leeks, for instance, will demolish all kinds of cancer cells in a culture. Whether these vegetables are still active in the busy metropolis of the body, with thousands of cellular processes going on at once, is another question: once the leek is chewed, swallowed, demolished by intestinal enzymes and absorbed into the blood, how likely are its molecules to brush up against a cancer cell, let alone engage it in armed combat? No one knows.
Among the militant foodists, Dr. Servan-Schreiber is something of a moderate. He warns against rejecting standard medical treatments for food-based therapy, and admits that much is unknown about exactly how powerful his vegetables are.
He is less reserved in a discussion of “the anticancer mind,” an enthusiastic re-creation of the archaic theory that a “cancer personality” — passive, saintly and repressed — enables tumors to flourish, while self-actualization makes them recede. Susan Sontag, who spent much of her intellectual muscle arguing exactly the reverse, would have had a field day with this section.
Still, this book is destined to sell widely and will probably become a bible in some homes. This fact alone makes it worth considering, not so much for what it says as for the clarity with which it illuminates the need it so deftly fills.
It is that old primal need to gain some control over a random and malevolent universe, the one (as any toddler’s relatives can attest) often won on the battleground of food. The popularity of books like this one makes it clear that for many adults there are two such universes to contend with: the malevolence of illness and that of orthodox medicine, somehow now perceived as conjoined enemies of health.
So these folks find control by heading determinedly to the supermarket and the refrigerator and the stove, the support groups, the treadmills and the massage tables. When it comes to cancer, these comforts are unlikely to hurt much, but the evidence is still out for whether they help.