Day 033 - 10 Oct 94 - Page 20


     
     1        a high fat diet, regardless of its fibre content, appears
     2        to be able to elevate oestrogen levels, which, we presume,
     3        is the mechanism by which it is associated with a higher
     4        risk of breast cancer.
     5
     6        Independent of that, increases in fibre do seem to be able
     7        to reduce oestrogen levels.  I do not know if that answers
     8        your question?
     9
    10   Q.   It is helpful to express your view in relation to cancer
    11        of the breast and, you would say, of the uterus and
    12        ovaries, because that is where your oestrogen element
    13        comes in.  It would not necessarily be so with relation to
    14        cancer of the colon, but we have not come to that yet?
    15        A.  Yes.
    16
    17   Q.   Perhaps you would bear in mind this enquiry when we do
    18        come to cancer of the colons.  All I am really inviting
    19        you to do -- there is no criticism -- if you mean high in
    20        fat and low in fibre, try to remember to put them both
    21        together rather than just high in fat; do you understand?
    22        A.  Yes, I will try to do that.
    23
    24   MR. MORRIS:  Just one point from what you said before.  You
    25        talked about latent cancers.  I think this is in regard to
    26        the prostate?
    27        A.  That is correct.
    28
    29   Q.   Do you want to explain that a little bit?
    30        A.  Yes.  When cancer begins in a cell a variety --
    31        several stages follow in sequence.  The first stage,
    32        called "initiation", means that the cell is no longer a
    33        normal cell, but there has been a change in the DNA of
    34        that cell, so that it is no longer capable of regulating
    35        its growth in a normal way.
    36
    37        If that cell then continues to grow, it will ultimately
    38        become a diagnosable cancer.  However, if it does not, if
    39        you simply have one or few abnormal cells that are not
    40        growing invading neighbouring tissues or spreading to
    41        distant sites, one can refer to that as a latent cancer.
    42
    43        In studies that have looked at fat intake and the
    44        incidence of latent prostate cancers, it has been shown
    45        that countries that have a higher fat intake -- I am
    46        taking care to be more specific here, setting aside the
    47        influence of fibre, for example -- those countries that
    48        tend to follow high fat diets have a higher incidence of
    49        latent cancers.  For example, in Sweden a study showed
    50        that the incidence of latent cancers in men, I believe, 
    51        over 45 years of age was ----- 
    52 
    53   Q.   Is this prostate cancer?
    54        A.  Yes, latent prostate cancers -- the studies are done
    55        on men who are killed traumatically or die from some other
    56        cause unrelated to prostate disease.  Their prostates are
    57        examined by researchers who go into the autopsy room and
    58        examine the prostate.  Men over the age of 45 in Sweden
    59        have about a 32 per cent incidence of latent cancers; men
    60        in Hong Kong of a similar age, similar circumstances, but

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