Day 033 - 10 Oct 94 - Page 29
1 MR. MORRIS: If we can move on to -- I believe you have touched
2 upon the dietary fat and survival of patients diagnosed
3 with cancer?
4 A. Yes, I think we have covered that. Perhaps just one
5 thing might be worth mentioning. For survival of
6 patients, obesity also can reduce survival in breast
7 cancer. A diet that is high in fat promotes obesity,
8 partly because it is high in calories typically but also
9 through other mechanisms. So, a high fat diet can
10 indirectly reduce survival of cancer patients.
11
12 The importance of this is not restricted to those
13 individuals who have already been diagnosed with cancer,
14 because cancer that arises on any particular day or week
15 or month is not likely to be diagnosed, for example, on
16 mammography, for eight to ten years. In other words, any
17 factor that affects survival of cancer patients is
18 important not only to those individuals who are carrying a
19 diagnosis of cancer, but for other individuals as well,
20 because it takes eight to ten years for a cancer to grow,
21 a breast cancer to grow, before it is visible on
22 mammography or palpable on examination.
23
24 When I say that a high fat diet impairs survival, I would
25 just caution against assuming that that is only important
26 for those individuals who are going to a clinic for cancer
27 treatment. This is important for everyone, because a
28 great many people have cancer cells now and they are not
29 yet diagnosed with cancer. If their diet is higher in
30 fat, they are more likely to come to a cancer diagnosis,
31 we presume, and almost certainly more likely to die of
32 that cancer. If their diet is quite low in fat their
33 course will be improved, according to a variety of
34 research studies. That is partly, but not solely, because
35 of the tendency of fat to cause obesity.
36
37 Q. I seem to have read somewhere -- I can be corrected if I
38 am wrong -- that in Britain something like 160,000 people
39 develop cancers each year. Presumably, in America that
40 would be a far greater figure. Do you happen to know?
41 A. Cancer is our second leading cause of death; one in
42 three Americans develops cancer at some point in their
43 lives. So, it is a very substantial cause of death.
44
45 Q. So we are talking about 70 million people, or something
46 like that, in America develop cancer in their lives?
47 A. Well, at some point in their life, assuming that they
48 live to a full life; yes, that is correct.
49
50 Q. So at any one time, assuming that cancer developed over a
51 period of ten, 20 years -- I cannot remember the figures,
52 but they are very substantial.
53
54 MR. JUSTICE BELL: I am not sure you can do the figures from
55 what you have been told. The 70 million is over a
56 lifetime period?
57 A. I did not mean to imply that everyone who is going to
58 die of cancer has cancer yet started. It begins at
59 different times in different individuals. All I was
60 trying to say, with regard to the evidence that we have on
