Day 033 - 10 Oct 94 - Page 30


     
     1        cancer survival, is that many, many, many individuals have
     2        not yet been diagnosed with cancer, but are carrying
     3        cancer cells.
     4
     5   Q.   You cannot, from the figures you have got, tell us how
     6        many of the population of the United States that is likely
     7        to be?
     8        A.  That is quite correct.
     9
    10   Q.   Mr. Morris says he cannot do a sum; no-one can actually do
    11        a sum, can they?
    12        A.  I am afraid I cannot be helpful.  I am sorry.
    13
    14   MR. MORRIS:  We are talking about tens of millions of people
    15        who may have cancer and they will not know for ten or
    16        twenty years.  So, what I am saying is, you were saying
    17        before about dietary prevention of cancer is not just in
    18        terms of the initiation of the cancer, but also for those
    19        that may have cancer that has not yet fully developed?
    20        A.  Yes.  To put it simply:  With regard to breast cancer,
    21        every woman who has been diagnosed with breast cancer, for
    22        eight years prior to her diagnosis she was carrying cancer
    23        cells in her breast but the cluster of cancer cells were
    24        too small for anyone to detect, too small for her to feel,
    25        too small for her doctor to detect on examination, and too
    26        small for a radiologist to see on mammography.
    27
    28        However, the dietary factors that influence prognosis were
    29        almost certainly operative before diagnosis as well as
    30        after.  So for those eight to ten years prior to diagnosis
    31        the dietary factors have no less importance.  We would
    32        presume that that is also true for something like prostate
    33        cancer and colon cancer, other forms of cancer, although
    34        breast cancer is the one that seems to have been looked at
    35        most with regard to survival.
    36
    37   MR. MORRIS:  If we move to the nurses' study -- was it American
    38        or Canadian nurses?
    39        A.  That was an American study.
    40
    41   Q.   This study -- you say it has come up before -- found a
    42        clear correlation with colon cancer; is that correct?
    43        A.  That is correct.
    44
    45   Q.   But it did not find a clear correlation with breast
    46        cancer?
    47        A.  That is correct.
    48
    49   Q.   Would you like to explain something about that?
    50        A.  Yes.  The study has identified certain factors and 
    51        failed to identify others.  There was a clear cut risk of 
    52        daily meat consumption.  Women who ate beef, pork or lamb 
    53        daily had a relative risk of colon cancer of 2.49, meaning
    54        two and a half times the risk of colon cancer compared to
    55        individuals who ate those products less than once per
    56        month.
    57
    58        The study also showed, as I mentioned earlier, that a low
    59        intake of vitamin A was identified as a risk factor for
    60        breast cancer.  However, it did not find a link or an

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