Day 035 - 12 Oct 94 - Page 14
1 form of words such as it has been postulated that, or it
2 is believed that, or it may be that? Do you understand?
3 So do not answer now; just give it a bit of thought.
4 A. Yes, thank you.
5
6 MR. RAMPTON: I will not waste the time of the court at the
7 moment. I should, however, like to be able to read the
8 whole of that in due course. My Lord, may we keep it on
9 our side for the moment?
10
11 MR. JUSTICE BELL: Yes, unless someone asks for it back.
12
13 MR. RAMPTON: Can we look at page 6 in the column headed Causes
14 and Prevention; do you have that?
15 A. Excuse me for one second, if I may, please? Yes,
16 page 6.
17
18 Q. Page 6, the column headed Causes and Prevention?
19 A. Yes, I am with you.
20
21 Q. "Scientists believe that cancers of the colon and rectum
22 develop over a period of many years as the result of
23 progressive changes in cells. Although both hereditary
24 and environmental factors appear to be involved, the
25 causes of these changes are not well understood. Doctors
26 can seldom explain why a particular person develops
27 colorectal cancer. In most cases, the onset of the
28 disease is probably triggered by complex interactions of
29 several factors. Among these are lifestyle and diet,
30 heredity, sporadic polyps, inflammatory bowel diseases,
31 and occupational exposure to carcinogens (cancer-causing
32 substances)".
33
34 If you go over to the next page, page 7, you see halfway
35 down the page, after a passage about Lifestyle, a passage
36 headed Diet: "Numerous animal experiments and population
37 studies suggest that the development of colorectal cancer
38 is linked to low intake of dietary fibre and that
39 increased dietary fibre has a protective effect".
40
41 I am going to pause there, Dr. Barnard, if I may, to ask
42 you two questions in the hope that I may not have to come
43 back to the topic. Do you accept that in relation to
44 cancer of the colon, and possibly the rectum, the
45 influence of diet is thought to be strongest in relation
46 to the promotion as opposed to the initiation of cancers?
47 A. No, I do not accept that -- well, let me ask you to
48 repeat the question before I give a response.
49
50 Q. Do you accept that the role of diet is most strongly
51 suggested by the evidence in relation to colon cancer in
52 relation to promotion rather than initiation?
53 A. Yes, I would agree with that, that there is a role for
54 diet in both initiation and in promotion, but that the
55 role in promotion is probably more decisive in the
56 patient's clinical course, although the role of foods in
57 initiation is also probably significant, particularly the
58 carcinogens I mentioned earlier that can cause genetic or,
59 presumably, can cause genetic changes in the bowel wall.
60
