Day 033 - 10 Oct 94 - Page 24
1 A. I see. In that particular sentence I was referring to
2 simply an association that one finds in the backgrounds of
3 cancer patients compared to other individuals who are like
4 them in many ways. One finds they have been eating diets
5 particularly high in fat, saturated fat, higher in
6 calories; one of the contributors to that, one of the
7 principal contributors would be meat.
8
9 MR. MORRIS: But, overall, on the subject of colon cancer and
10 the link between that and the kind of diet which is
11 specified, would you say that was a causal link, an
12 associative link or indirect link -- what kind of link?
13 A. The link is almost certainly causal. That is not
14 simply -- I say that not simply from the evidence we have
15 presented so far, but there is also evidence that
16 when -- let me back up for a moment, if I may -- when
17 colon cancer begins it can often begin as a polyp, and if
18 one can prevent the onset of polyps, one can reduce the
19 incidence of cancer developing.
20
21 It has been shown that when fibre is added to the diets of
22 individuals who have already been diagnosed with polyps,
23 the likelihood of those recurring can be modified,
24 indicating that, in fact, the link, if you will, must be
25 causal; that a high fibre diet increases the likelihood of
26 cancer developing in the colon. A high fibre diet can
27 reduce that risk, and that this is not simply an
28 association but that, in fact, the diet is changing the
29 body in such a way that cancer is more likely to grow or
30 more likely to progress in individuals where the diet is
31 high in fat and less likely when the diet is high in
32 fibre.
33
34 MR. JUSTICE BELL: So one might think the fact that if you add
35 something to diet that gives you a better chance once
36 cancer is diagnosed; it does not mean that it is a lack of
37 it which has caused cancer, but, to your mind, it does
38 mean that or it is an indication of that, is it?
39 A. The fibre intake of individuals in western countries
40 is quite low compared to that of other countries. If one
41 increases the fibre intake of individuals who have had a
42 history of colonic polyps to match that of -- this is
43 typical of under developed countries -- one can reduce the
44 likelihood of recurrence.
45
46 So, by that I guess I might say one is taking one step to
47 normalise the diet or return it to a -- to return the diet
48 to that which is more helpful for the body.
49
50 MR. MORRIS: Could you explain what polyps are, their
51 relationship with cancer?
52 A. Yes, P-O-L-Y-P-S. Polyps are benign growths that are
53 -- that seem to be one of the initial changes that
54 ultimately will lead to cancer of the colon.
55
56 Q. So polyps are not in themselves cancerous?
57 A. That is correct, but they are an indication that that
58 individual is at a substantially higher risk of cancer.
59
60 Q. Obviously, we could probably talk all day about link and
