Day 033 - 10 Oct 94 - Page 25


     
     1        types of link, but -----
     2
     3   MR. JUSTICE BELL:  I only asked so I could understand.  All
     4        I am concerned with is that I have it clear in my mind
     5        where words like "linked to" or "associated with" or
     6        "going hand in hand with" that I see whether it is meant
     7        that they have a causative effect.  Since I have noticed
     8        that sentence in Dr. Barnard's statement, I wanted to know
     9        what he meant there.
    10
    11   THE WITNESS:  Regrettably, physicians do tend to use that sort
    12        of terminology much too much when, perhaps, we mean
    13        something more specific.
    14
    15   MR. MORRIS:  On that subject, when you are putting information
    16        over to the public, are you able to go into medical
    17        terminology?  That is something you are concerned with,
    18        getting information to the public.  Do you want to comment
    19        on that, about the kind of terminology you need to use?
    20        A.  I am not quite sure I understand the question.
    21
    22   Q.   I have gone right off the subject.
    23
    24   MR. JUSTICE BELL:  You can come back to it if you want to.  You
    25        were going on to pancreatic cancer.
    26
    27   MR. MORRIS:  I was concerned about the last point when you
    28        said:  "Once a cancer is established" -- I believe --
    29         "dietary changes can improve the outlook"; is that
    30        correct?
    31        A.  Are you speaking of colon cancer in particular?
    32
    33   Q.   I think so, yes.  You drew some conclusions on that; is
    34        that what you said?  Sorry?
    35        A.  We have -- there has been an assumption, going back to
    36        Burkitt's work which was published in 1971 and predicated
    37        on work that occurred earlier, that fibre was protective
    38        against colon cancer.  In fact, further evidence of that,
    39        that the inverse relationship between fibre and colon
    40        cancer that is not simply an inverse association but, in
    41        fact, it is cause and effect, comes from the fact that
    42        when individuals, who have already been diagnosed with
    43        cancer or with polyps, are put on diets that are
    44        intentionally higher in fibre, the likelihood of
    45        recurrence (which is the problem we have with cancer) is
    46        reduced.  The likelihood of recurrences is reduced,
    47        indicating that, in fact, yes, fibre is protective.  And
    48        one postulates that had that individual been on a higher
    49        fibre diet prior to their initial diagnosis, inevitably in
    50        some of these cases cancer may never have occurred at all. 
    51 
    52   Q.   But, presumably, this relates to various stages of cancer, 
    53        for example, whether it is a latent initiation, latency
    54        promotion, development, spreading?
    55        A.  Yes.  There is a form of colon cancer in which the
    56        cancer is isolated to the colon itself; it has not spread;
    57        it is not even through the wall of the colon; it has not
    58        got into the blood stream and spread elsewhere in the
    59        body.
    60

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